Correlation between CT perfusion parameters and Fuhrman grade in pTlb renal cell carcinoma
- 194 Downloads
To evaluate the correlation of CT perfusion parameters with the Fuhrman grade in pT1b (4–7 cm) renal cell carcinoma (RCC).
CT perfusion imaging and Fuhrman pathological grading of pT1b RCC were performed in 48 patients (10 grade 1, 27 grade 2, 9 grade 3, and 2 grade 4). Equivalent blood volume (BV Equiv), permeability surface area product (PS), and blood flow (BF) of tumors were measured. Grade 1 and 2 were defined as low-grade group (n = 37), meanwhile high-grade group (n = 11) included grade 3 and 4. Comparisons of CT perfusion parameters and tumor size of the two different groups were performed. Correlations between CT perfusion parameters, Fuhrman grade (grade 1, 2, 3, and 4), and tumor size were assessed.
PS was significantly lower in high grade than in low-grade pT1b RCC (P = 0.004). However, no significant differences were found in BV Equiv and BF between the two groups (P > 0.05 for both). The optimal threshold value, sensitivity, specificity, and the area under the ROC curve for distinguishing the two groups using PS were 68.8 mL/100 g/min, 0.7, 0.8, and 0.8, respectively. Negative significant correlation was observed between PS and Fuhrman grade (r = −0.338, P = 0.019).
The PS of pT1b RCC had negative significant correlation with Fuhrman grade. CT perfusion appeared to be a non-invasive means to predict high Fuhrman grade of pT1b RCC preoperatively and guide the optimal treatment for the patient.
KeywordsComputed tomography Perfusion imaging Renal cell carcinoma Fuhrman grade
The authors thank Chaan S Ng, M.D., of Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center for good advice on writing in this study.
Compliance with ethical standards
No funding was received for this study.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.
Statement of informed consent was not applicable since the manuscript does not contain any patient data.
- 5.Edge SB, American Joint Committee on Cancer (2010) AJCC cancer staging manual. New York: Springer, p 648Google Scholar
- 17.Zhang YD, Wu CJ, Wang Q, et al. (2015) Comparison of utility of histogram apparent diffusion coefficient and R2* for differentiation of low-grade from high-grade clear cell renal cell carcinoma. AJR Am J Roentgenol 205(2):W193–W201. doi: 10.2214/AJR.14.13802 CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Vargas HA, Delaney HG, Delappe EM, et al. (2013) Multiphasic contrast-enhanced MRI: single-slice versus volumetric quantification of tumor enhancement for the assessment of renal clear-cell carcinoma fuhrman grade. J Magn Reson Imaging 37(5):1160–1167. doi: 10.1002/jmri.23899 CrossRefPubMedPubMedCentralGoogle Scholar
- 27.Villalobos-Gollas M, Aguilar-Davidov B, Culebro-Garcia C, et al. (2012) Pathological implications of areas of lower enhancement on contrast-enhanced computed tomography in renal-cell carcinoma: additional information for selecting candidates for surveillance protocols. Int Urol Nephrol 44(5):1369–1374. doi: 10.1007/s11255-012-0199-8 CrossRefPubMedGoogle Scholar