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ECR 2019 / C-2630
Differentiation between clear cell renal cell carcinoma from other renal cell carcinoma subtypes: qualitative and quantitative multiphasic CT analysis
Congress: ECR 2019
Poster No.: C-2630
Type: Scientific Exhibit
Keywords: Pathology, Neoplasia, Efficacy studies, CT, Urinary Tract / Bladder, Kidney, Abdomen
Authors: M. H. Verussa1, F. M. A. Coelho2, M. FUKUMOTO1, B. A. Vento1, R. Gianordoli1, S. Horta1, F. I. Yamauchi1, P. Viana1; 1São Paulo/BR, 2São Paulo, São Paulo/BR
DOI:10.26044/ecr2019/C-2630

Results

In total, 1,100 patients were diagnosed with a renal mass, being 153 included in this sample with a unique lesion. Among these, 108 (70,6 %) were clear cell renal cell RCC, 30 (19,6 %) were papillary RCCs, and 15 (9,8 %) were chromophobe RCCs. The baseline characteristics for each of the groups are demonstrated in Table 1.

 

 

Table 1: Epidemiology characteristics of all lesions and subgroups.
References: Instituto de Radiologia - InRad, Universidade de São Paulo, Hospital das Clínicas - São Paulo/BR

 

 

Objective evaluation

The mean attenuation measurements according to each group are listed in Table 2.

 

Table 2: Attenuation of renal masses on the basis of histologic subtype.
References: Instituto de Radiologia - InRad, Universidade de São Paulo, Hospital das Clínicas - São Paulo/BR

 

In corticomedullary phase, enhancement of clear cell RCCs was significantly greater than that of papillary RCCs (137 HU vs 60 HU, P = .001), such as greater than that of chromophobe RCCs (137 HU vs 96 HU, P = .001).

In nephrographic phase, the enhancement attenuation of clear cell RCCs was also significantly greater than that of papillary RCCs (117 HU vs 70 HU, P = .001) such as greater than that of chromophobe RCCs nephrographic (117 HU vs 88 HU, P = .001).

Enhancement of clear cell RCCs was significantly greater than that of papillary RCCs in the excretory (75 HU vs 59 HU, P = .001) phase, such as greater than that of chromophobe RCCs (75 HU vs 60 HU, P = .015).

  

Subjective evaluation

Subjective features are listed in Table 3.

Qualitative features that aid the differentiation between clear cell RCCs and papillary RCCs were necrosis (65/108 vs 5/30, P < .001), contrast enhancement pattern (P < .001) and washout (82/108 vs 1/30, P < .001), and between clear cell RCCs and chromophobe RCCs were necrosis (65/108 vs 3/15, P = .009), contrast enhancement pattern (P < .001), washout (82/108 vs 6/15, P = .012) and vessels into the lesion (7/108 vs 4/15, P = .03).

 

 

Table 3: Imaging features of renal masses on the basis of histologic subtype.
References: Instituto de Radiologia - InRad, Universidade de São Paulo, Hospital das Clínicas - São Paulo/BR

 

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