Association of tumor grade, enhancement on multiphasic CT and microvessel density in patients with clear cell renal cell
- PDF / 1,229,490 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 47 Downloads / 155 Views
KIDNEYS, URETERS, BLADDER, RETROPERITONEUM
Association of tumor grade, enhancement on multiphasic CT and microvessel density in patients with clear cell renal cell carcinoma Heidi Coy1 · Jonathan R. Young2 · Allan J. Pantuck3 · Michael L. Douek1 · Anthony Sisk4 · Clara Magyar4 · Matthew S. Brown5 · James Sayre6 · Steven S. Raman7
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Purpose Clear cell renal cell carcinoma (ccRCC) comprises nearly 90% of all diagnosed RCC subtypes and has the worst prognosis and highest metastatic potential. The strongest prognostic factors for patients with ccRCC include histological subtype and Fuhrman grade, which are incorporated into prognostic models. Since ccRCC is a highly vascularized tumor, there may be differences in enhancement patterns on multidetector CT (MDCT) due to the hemodynamics and microvessel density (MVD) of the lesions. This may provide a noninvasive method to characterize incidentally detected low- and highgrade ccRCCs on MDCT. The purpose of our study was to determine the correlation between MDCT enhancement parameters, ccRCC MVD, and Fuhrman grade to determine its utility and value in assessing tumor vascularity and grade in vivo. Methods In this retrospective, HIPAA-compliant, institutional review board-approved study with waiver of informed consent, 127 consecutive patients with 89 low-grade (LG), and 43 high-grade (HG) ccRCCs underwent preoperative four-phase MDCT. A 3D volume of interest (VOI) was obtained for every tumor and absolute enhancement and the wash-in/wash-out of enhancement for each phase was assessed. Immunohistochemistry on resected specimens was used to quantify MVD. Linear regression and Pearson correlation were used to investigate the strength of the association between 3D VOI enhancement and MVD. Stepwise logistic regression analysis determined independent predictors of HG ccRCC. Cut-off values and odds Ratio (OR) with 95% CIs were reported. The clinical, radiomic, and pathologic features with the highest performance in the stepwise logistic regression analysis were evaluated using receiver operator characteristics (ROC) and area under the curve (AUC). Results Absolute enhancement in the nephrographic phase 4.3 cm (HR 1.450, 95% CI 1.211–1.738, p value
Data Loading...
