Differential diagnosis of chromophobe renal cell carcinoma and papillary renal cell carcinoma with dual-energy spectral computed tomography

Wang, Dan; Huang, Xiaoyu; Bai, Liangcai; Zhang, Xueling; Wei, Jinyan; Zhang, Junlin

doi:10.1177/0284185120903447

Cited by 8 publications

(8 citation statements)

References 34 publications

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“…Consistent with our findings, Wei et al explored the differentiation between Xp11.2 tRCC and ccRCC using CEUS and found that lower peak enhancement was more likely to occur in Xp11.2 tRCC than in ccRCC 17 . Nevertheless, pRCC tumors are the most common hypovascular renal tumors and also affect older men 4,34 . Because the histomorphological and radiological findings of Xp11.2 tRCC are extremely similar to those of pRCC; 28 it is difficult to differentiate between Xp11.2 tRCC and pRCC.…”

Section: Discussionsupporting

confidence: 84%

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

Fan

Huang

et al. 2022

J of Ultrasound Medicine

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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.

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Section: Discussionsupporting

confidence: 84%

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

Fan

Huang

et al. 2022

J of Ultrasound Medicine

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“…Moreover, DESCT has been widely used in clinical practice to identify and malignant lymph nodes, evaluate the response to neoadjuvant treatment, and evaluate microsatellite instability status in patients with CRC (11)(12)(13)(14). Previously published studies have also demonstrated the value of energy spectrum CT in other abdominal tumors, including pathological grading of clear cell renal cell carcinoma (15), differential diagnosis of chromophobe renal cell carcinoma and papillary renal cell carcinoma (16), risk classification of gastrointestinal stromal tumor (17), distinguishing between gastric schwannomas and gastrointestinal stromal tumors (18), and identifying liver cancer and hepatic focal nodular hyperplasia (19). Nomograms have been widely used to quantify the risk factors of CRC biological characteristics (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Development of a dual-energy spectral computed tomography-based nomogram for the preoperative discrimination of histological grade in colorectal adenocarcinoma patients

Cao¹,

Zhang²,

Bao³

et al. 2021

J Gastrointest Oncol

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Background: The usefulness of a dual-energy spectral computed tomography (DESCT)-based nomogram in discriminating between histological grades of colorectal adenocarcinoma (CRAC) is unclear. This study aimed to develop such a nomogram and assess its ability to preoperatively discriminate between histological grades in CRAC patients. Methods: Primary tumors monochromatic CT value, iodine concentration (IC) value, and effective atomic number (Eff-Z) in the arterial (AP) and venous phases (VP) were retrospectively compared between patients with high-grade (n=65) and low-grade (n=108) CRAC who underwent preoperative abdominal DESCT.Univariate analysis was used to compare the DESCT parameters and clinical factors between these two patient groups. Statistically significant features in the univariate analysis were included in the multivariate logistic regression model to identify the indicators for building a nomogram that could discriminate between histological grades in CRAC patients. The clinical usefulness of the nomogram and its value for predicting overall survival were statistically evaluated. Results: The logistic regression analysis showed that age, clinical T stage, clinical N stage, and IC values in AP and VP were significant independent predictors for high-grade CRAC. A quantitative nomogram developed based on these predictors showed excellent performance for discriminating between the histological grades, with an area under the curve (AUC) of 0.886 and excellent agreement in the calibration curve. The Kaplan-Meier curve for overall survival showed that our nomogram identified a significant difference between the high-and low-risk groups [hazard ratio (HR), 2.188; 95% CI, 1.072-4.465; P=0.027). Conclusions: This study presents a nomogram that incorporates DESCT parameters and clinical factors and can potentially be used as a clinical tool for individual preoperative prediction of CRAC histological grade.

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“…Energetic-spectrum computed tomography (spectral CT) is able to provide iodinebased material decomposition image and quantitatively analyze the iodine concentration (IC) of normal tissues and lesions in enhanced images. IC possesses a certain value in the imaging diagnosis, pathological grading and differential diagnosis of RCC [ 12 , 13 ]. However, only a few studies pay close attention to the relationship between IC derived from spectral CT and RCC angiogenesis.…”

Section: Introductionmentioning

confidence: 99%

Effect of spectral CT on tumor microvascular angiogenesis in renal cell carcinoma

Zhang

Qiu

et al. 2021

BMC Cancer

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Background To examine the value of energetic-spectrum computed tomography (spectral CT) quantitative parameters in renal cell carcinoma (RCC) microvascular angiogenesis. Methods The authors evaluated 32 patients with pathologically confirmed RCC who underwent triple-phase contrast-enhanced CT with spectral CT imaging mode from January 2017 to December 2019. Quantitative parameters include parameters derived from iodine concentration (IC) and water concentration (WC) of 120 keV monochromatic images. All specimens were evaluated including the microvascular density (MVD), microvascular area (MVA) and so on. The correlation between IC and WC (including average values and random values) with microvascular parameters were analyzed with Pearson or Spearman rank correlation coefficients. Results The MVD of all tumors was 26.00 (15.00–43.75) vessels per field at × 400 magnification. The MVD of RCC correlated positively with the mean IC, mean WC, mean NWC, mean NIC, random IC, random NIC in renal cortical phase, WCD1, WCD2, NWCD2 and ICD1 (Spearman rank correlation coefficients, r range, 0.362–0.533; all p < 0.05). The MVA of all tumors was (16.16 ± 8.98) % per field at × 400 magnification. The MVA of RCC correlated positively with the mean IC, mean WC, mean NWC, mean NIC, random IC, random NIC in renal cortical, mean WC and mean NWC in renal parenchymal phase, WCD1, WCD2, WCD3, NWCD2, and NWCD3 (Pearson or Spearman rank correlation coefficients, r range, 0.357–0.576; all p < 0.05). Microvascular grading correlated positively with the mean NWC, mean NIC and random NIC in renal cortical phase, mean NWC in renal parenchymal phase, NWCD2, WCD3, NWCD3, NICD2 and NICD3 (Spearman rank correlation coefficients, r range, 0.367–0.520; all p < 0.05). As for tumor diameter (55.19 ± 19.15), μm, only NWCD3 was associated with it (Spearman rank correlation coefficients, r = 0.388; p < 0.05). Conclusions ICD and WCD of spectral CT have a potential for evaluating RCC microvascular angiogenesis. MVD, MVA and microvascular grade showed moderate positive correlation with ICD and WCD. ICD displayed more relevant than that of WCD. The parameters of renal cortical phase were the best in three phases. NICD and NWCD manifested stronger correlation with microvascular parameters than that of ICD and WCD.

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Differential diagnosis of chromophobe renal cell carcinoma and papillary renal cell carcinoma with dual-energy spectral computed tomography

Cited by 8 publications

References 34 publications

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

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

Development of a dual-energy spectral computed tomography-based nomogram for the preoperative discrimination of histological grade in colorectal adenocarcinoma patients

Effect of spectral CT on tumor microvascular angiogenesis in renal cell carcinoma

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