Clear cell renal cell carcinoma and papillary renal cell carcinoma: differentiation of distinct histological types with multiphase CT

Abstract

ABDOMINAL IMAGINGORIGINAL ARTICLE PURPOSE Conventional clear cell renal cell carcinoma (ccRCC) and papillary renal cell carcinoma (pRCC) have different behavioral characteristics and clinical management strategies (nephrectomy vs. nephron-sparing surgery). Our aim was to retrospectively evaluate the contrast enhancement pattern of ccRCC and pRCC and evaluate its possible diagnostic role for preoperative differentiation using a standardized protocol. MATERIALS AND METHODSQuadriphasic multidetector computed tomography (CT) images (unenhanced, corticomedullary, nephrographic, and excretory phases) of 19 patients with 20 ccRCC and 14 patients with 15 pRCC lesions (mean ages, 62.3±14.1 and 61.4±13.7 years, respectively) were reviewed retrospectively. The attenuation characteristics were compared with the attenuation of the normal renal cortex using either multiple 10 mm 2 regions of interest or whole tumor attenuation measurements. The degree of contrast enhancement was also compared. RESULTSUnivariate analysis revealed that ccRCC lesions showed higher mean attenuation values on the corticomedullary and nephrographic phases compared with pRCC masses (P < 0.05) using both measurement techniques. CONCLUSIONThe findings underscore the importance of multiphase CT in the differentiation of these two subtypes of RCC using standard assessment techniques. The measurement of the degree of enhancement on contrast-enhanced multidetector CT may be a simple and useful method to radiologically differentiate between the two histological types of RCC.

Differential radiologic characteristics of renal tumours on multiphasic computed tomography

“…Previous studies have demonstrated that multiphasic CT (12)(13)(14) and magnetic resonance imaging (15) can be useful in differentiating ccRCCs from pRCCs. The results of the present study provided independent validation and showed that both attenuation and degree of enhancement in the nephrographic phase are significantly lower for pRCCs than ccRCCs.…”

“…mixed RCCs), such as those with clear cell and papillary appearances, are generally less well described. Previous studies have focused on differentiating ccRCCs from pRCCs using multiphasic computed tomography (CT) (12)(13)(14) and there has been little emphasis on oncocytomas or chRCCs. To the best of our knowledge, the radiological characteristics of mixed RCCs have not been described.…”

Multidetector CT imaging features of invasive renal parenchyma urothelial carcinoma

“…Therefore, it may be easy to distinguish between IRPUC and tumours with a rich blood supply by the degree of enhancement. 22 In common with IRPUCs, collecting duct carcinomas, chromophobe renal cell carcinomas 23 and renal lymphomas are hypovascular compared with renal parenchyma on enhanced CT imaging. The majority of collecting duct carcinomas 24 show mild enhancement on all enhanced scan phases.…”

Comparison of biexponential and monoexponential DWI in evaluation of Fuhrman grading of clear cell renal cell carcinoma

“…Thus, a precise diagnosis of preoperative Fuhrman grade becomes sufficiently important. As noninvasive assessment modalities, computed tomography (CT) and magnetic resonance imaging (MRI) have been used to determine therapeutic strategies and surgical planning in RCC (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18).…”