Diagnostic Accuracy of MRI for Detecting Inferior Vena Cava Wall Invasion in Renal Cell Carcinoma Tumor Thrombus Using Quantitative and Subjective Analysis

Alayed, Abdullah; Krishna, Satheesh; Breau, Rodney H.; Currin, Steven; Flood, Trevor A.; Narayanasamy, Sabarish; Schieda, Nicola

doi:10.2214/ajr.18.20209

Cited by 20 publications

(9 citation statements)

References 29 publications

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“…A previous study conducted by Alayed et al. found that TV can be an excellent indicator of IVC wall invasion ( 17 ). In addition, we found that there are several patients with a Mayo grade I tumor, who have similar operative times, similar intraoperative blood loss, and similar incidence of postoperative complications as those with Mayo grade III or IV.…”

Section: Discussionmentioning

confidence: 98%

The Significant Role of Tumor Volume on the Surgical Approach Choice, Surgical Complexity, and Postoperative Complications in Renal Cell Carcinoma With Venous Tumor Thrombus From a Large Chinese Center Experience

Baheen

Liu²,

Hao³

et al. 2022

Front. Oncol.

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ObjectiveTo explore the role of tumor volume (TV) on surgical approach choice, surgical complexity, and postoperative complications in patients with renal cell carcinoma (RCC) and inferior vena cava tumor thrombus.MethodFrom January 2014 to January 2020, we retrospectively analyzed the clinical data of 132 patients who underwent radical nephrectomy with inferior vena cava thrombectomy (RN-IVCT). Primary renal tumor volume (PRTV), renal vein tumor thrombus volume (RVTTV), inferior vena cava tumor thrombus volume (IVCTTV), and total tumor thrombus volume (TTTV) were measured with the help of an internationally recognized 3D volume measurement software. The patients were divided into three groups according to the tumor volume within the inferior vena cava (IVC). Group 1 included 48 patients with IVCTTV between 0 and 15 cm3 (36.6%), group 2 included 38 patients with IVCTTV between 16 and 30 cm3 (28%), and group 3 included 46 patients with IVCTTV above 30 cm3 (35%). The three IVCTTV groups, as well as four different volume groups, were compared in terms of surgical approach choice, surgical complexity, and postoperative complications. One-way ANOVA and a non-parametric test were used to compare the clinicopathological characteristics and distribution differences between the three groups.ResultThis study found significant differences among the three groups in the proportion of open surgery (P < 0.001), operation time (P < 0.044), intraoperative bleeding (P < 0.001), and postoperative complications (P < 0.001). When the four different volumes were compared, we found that for higher volumes IVCTTV and TTTV, open surgery is used more often compared with laparoscopic surgery (P < 0.001). In addition, with the increase in renal vein tumor thrombus volume, inferior vena cava tumor thrombus volume, and total tumor thrombus volume, the operation time also increased. Finally, with the increase in tumor thrombus volume and total tumor thrombus volume, the amount of intraoperative bleeding increased.ConclusionWith the increase in tumor volume, the proportion of open surgery and the incidence of postoperative complications increased. In addition, larger tumor volume prolongs operation time, increases intraoperative blood loss, and makes the surgery more complicated.

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Section: Discussionmentioning

confidence: 98%

The Significant Role of Tumor Volume on the Surgical Approach Choice, Surgical Complexity, and Postoperative Complications in Renal Cell Carcinoma With Venous Tumor Thrombus From a Large Chinese Center Experience

Baheen

Liu²,

Hao³

et al. 2022

Front. Oncol.

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“…Although MR is regarded as the optimal examination method, it is still a challenge for radiologists to evaluate IVC invasion. Using the imaging signs and quantitative measurements on MRI, radiologists’ evaluations of IVC wall invasion have a sensitivity and specificity of 63.6-100.0% and 86.4-92.3%, respectively ( 14 , 15 , 17 ). In this study, the radiological model incorporating irregular margin of TT and abnormal signal intensity on T2WI also yielded a moderate sensitivity of 75.0% and specificity of 73.3%.…”

Section: Discussionmentioning

confidence: 99%

“…Several signatures based on MRI have been proposed for predicting invasion of the IVC wall with good histopathological correlation ( 14 – 16 ). Among them, a large volume of the TT and subjective features of complete occlusion of the IVC lumen, irregular margin of the TT, thickened IVC wall, and abnormal signal of the IVC wall are the most common ( 14 , 15 , 17 – 19 ). However, subjective evaluation is empirically dependent and has achieved only a moderate degree of consistency and accuracy.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative Prediction of Inferior Vena Cava Wall Invasion of Tumor Thrombus in Renal Cell Carcinoma: Radiomics Models Based on Magnetic Resonance Imaging

Sun

Cui

et al. 2022

Front. Oncol.

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ObjectiveTo develop radiomics models to predict inferior vena cava (IVC) wall invasion by tumor thrombus (TT) in patients with renal cell carcinoma (RCC).MethodsPreoperative MR images were retrospectively collected from 91 patients with RCC who underwent radical nephrectomy (RN) and thrombectomy. The images were randomly allocated into a training (n = 64) and validation (n = 27) cohort. The inter-and intra-rater agreements were organized to compare masks delineated by two radiologists. The masks of TT and IVC were manually annotated on axial fat-suppression T2-weighted images (fsT2WI) by one radiologist. The following models were trained to predict the probability of IVC wall invasion: two radiomics models using radiomics features extracted from the two masks (model 1, radiomics model_IVC; model 2, radiomics model_TT), two combined models using radiomics features and radiological features (model 3, combined model_IVC; model 4, combined model_TT), and one radiological model (model 5) using radiological features. Receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA) were applied to validate the discriminatory effect and clinical benefit of the models.ResultsModel 1 to model 5 yielded area under the curves (AUCs) of 0.881, 0.857, 0.883, 0.889, and 0.769, respectively, in the validation cohort. No significant differences were found between these models (p = 0.108-0.951). The dicision curve analysis (DCA) showed that the model 3 had a higher overall net benefit than the model 1, model 2, model 4, and model 5.ConclusionsThe combined model_IVC (model 3) based on axial fsT2WI exhibited excellent predictive performance in predicting IVC wall invasion status.

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“…RCC ranks second in malignant tumors of the urinary system, accounting for 3% of all solid tumors. With the continuous advancement of modern diagnostic technology, clinical cases of RCC have gradually increased [16]. However, 50% of RCC patients will metastasize after surgery.…”

Section: Discussionmentioning

confidence: 99%

Chinese Medicine Leptochloa chinensis Inhibits the Malignant Behaviors of Renal Cell Carcinoma 786-O Cells by Regulating the mTOR Pathway

Tan

Liu

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Background. Renal cell carcinoma (RCC) is a common malignant tumor of the urinary system that seriously threatens human life and health. This study aims to explore the role of the traditional Chinese medicine Leptochloa chinensis in the pathogenesis of RCC. Meanwhile, this study also revealed the molecular biological mechanism of its antitumor activity. Methods. Human RCC 786-O cells were cultured in the RPMI-1640 medium, which contains different concentrations of Leptochloa chinensis (1,000, 3,000, and 9,000 μg/ml). MTT and flow cytometry assays were used to detect the viability of 786-O cells. Transwell and wound healing assays were used to detect cell metastasis. The protein expression was observed by western blot analysis. Results. Leptochloa can inhibit cell proliferation and induce apoptosis in RCC 786-O cells. In addition, Leptochloa can weaken the migration and invasion of 786-O cells. More importantly, Leptochloa can block the mTOR pathway by inhibiting the protein expression of p-mTOR. Moreover, the high concentration of Leptochloa chinensis has a better inhibitory effect on 786-O cells. Conclusion. The traditional Chinese medicine Leptochloa chinensis inhibits the viability and metastasis of 786-O cells by blocking the mTOR pathway.

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Diagnostic Accuracy of MRI for Detecting Inferior Vena Cava Wall Invasion in Renal Cell Carcinoma Tumor Thrombus Using Quantitative and Subjective Analysis

Cited by 20 publications

References 29 publications

The Significant Role of Tumor Volume on the Surgical Approach Choice, Surgical Complexity, and Postoperative Complications in Renal Cell Carcinoma With Venous Tumor Thrombus From a Large Chinese Center Experience

The Significant Role of Tumor Volume on the Surgical Approach Choice, Surgical Complexity, and Postoperative Complications in Renal Cell Carcinoma With Venous Tumor Thrombus From a Large Chinese Center Experience

Preoperative Prediction of Inferior Vena Cava Wall Invasion of Tumor Thrombus in Renal Cell Carcinoma: Radiomics Models Based on Magnetic Resonance Imaging

Chinese Medicine Leptochloa chinensis Inhibits the Malignant Behaviors of Renal Cell Carcinoma 786-O Cells by Regulating the mTOR Pathway

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