Contrast‐Enhanced Ultrasound Features of Adult Xp11.2 Translocation Renal Cell Carcinoma

Abstract

Objectives To investigate the sonographic features in Xp11.2 translocation renal cell carcinoma (Xp11.2 tRCC) using both conventional ultrasound (US) and contrast‐enhanced US (CEUS) and evaluate the usefulness of sonographic imaging characteristics to differentiate between Xp11.2 tRCC and the three common RCC subtypes. Methods Thirty‐four adult Xp11.2 tRCC patients who preoperatively underwent both conventional US and CEUS and had solitary renal lesions and pathological confirmation after surgery were enrolled. Control matched patients included 131 with clear cell RCC (ccRCC), 48 with papillary RCC (pRCC), and 35 with chromophobe RCC (chRCC). Conventional US and CEUS data of all patients were retrospectively analyzed and compared. Results Xp11.2 tRCC was more common in young women. The echogenicity of Xp11.2 tRCC lesions was hypo‐ and isoechoic relative to the adjacent renal cortex. A higher frequency of calcification within tumors was detected in Xp11.2 tRCC, but the presence of color flow signal (26.5%, 9/34) was much lower. Regarding CEUS features relative to the adjacent renal cortex, synchronous wash‐in (61.8%, 21/34), iso‐enhancement at peak (55.9%, 19/34), and fast wash‐out (50.0%, 17/34) were more common in Xp11.2 tRCC. Moreover, an integrated variables model based on these features could differentiate Xp11.2 tRCC from ccRCC, pRCC, and chRCC (area under the curve, sensitivity, and specificity: 0.934, 92.0%, and 86.0%; 0.907, 88.0%, and 87.0%; and 0.808, 65.0%, and 99.0%, respectively). Conclusions Combining conventional US and CEUS lesion features with clinical information may provide a feasible and effective method to differentiate Xp11.2 tRCC from ccRCC, pRCC, and chRCC.

Multimodality imaging of Xp11.2 translocation/TFE3 gene fusion associated with renal cell carcinoma: a case report

“…CEUS offers numerous advantages, including noninvasiveness, real-time imaging capabilities, and the accurate assessment of renal tumor characteristics and vascularity. In a study conducted by Ma et al ( 23 ), fast wash-out patterns were identified as the primary features of Xp11.2 RCC. Furthermore, Wei et al ( 24 ) investigated the differentiation between Xp11.2 RCC and clear cell type renal cell carcinoma (ccRCC) using CEUS and found that Xp11.2 RCC exhibited lower peak enhancement compared to ccRCC.…”

Qualitative and quantitative characteristics of CEUS for renal cell carcinoma and angiomyolipoma: a narrative review

“…This is likely due to blood vessel abnormalities, including thickened vessel walls and variable amounts of slowly growing adipose tissue, with less frequent necrosis and ischemia in the adjacent renal parenchyma [ 24 ]. These characteristics explain a more frequent homogeneous pattern and the rare presence of the perilesional border, unlike RCCs [ 25 ]. Occasionally, AMLs, especially those larger than 4 cm, may display spontaneous hemorrhages with a heterogeneous pattern on CEUS [ 18 ].…”