Abstract
Purpose
To determine whether multiphasic MDCT enhancement can help identify the gain of chromosome 12 in clear cell renal cell carcinomas (RCCs).
Methods
With IRB approval for this HIPAA-compliant case control study, we derived a cohort of 65 clear cell RCCs with preoperative four-phase renal mass MDCT from October 2000 to August 2013. Each lesion was segmented in its entirety on axial images in all phases. A computer-assisted detection (CAD) algorithm selected a 0.5-cm-diameter region of maximal attenuation within each lesion in each phase. Attenuation in each phase between clear cell RCCs with and without the gain of 12 was compared using t-tests.
Results
While the entire cohort of clear cell RCCs exhibited peak enhancement in the corticomedullary phase, the subcohort of lesions with the gain of 12 exhibited significantly greater enhancement in the nephrographic (179 vs. 145 HU, p = 0.004) and excretory phases (147 vs. 118 HU, p = 0.004) than the subcohort of lesions without the gain of 12. A nephrographic threshold of 186 HU identified the gain of 12 with an accuracy of 86% (56/65), specificity of 93% (51/55), and negative predictive value of 91% (51/56).
Conclusion
Multiphasic MDCT enhancement, specifically enhancement in the nephrographic and excretory phases, may potentially assist in identifying the gain of 12 in clear cell RCCs.
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Acknowledgments
We thank the UCLA Computer Vision and Imaging Biomarker (CVIB) group, including Dr. Jonathan Goldin, Dr. Matthew Brown, Moe Moe Ko, and War War Ko, for their assistance with this study.
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Jonathan R. Young, Heidi Coy, Michael Douek, Pechin Lo, James Sayre, Allan J. Pantuck, and Steven S. Raman declare that they have no conflict of interest.
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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.
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The Institutional Review Board waived the requirement of informed consent for this study.
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Young, J.R., Coy, H., Douek, M. et al. Clear cell renal cell carcinoma: identifying the gain of chromosome 12 on multiphasic MDCT. Abdom Radiol 42, 236–241 (2017). https://doi.org/10.1007/s00261-016-0868-7
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DOI: https://doi.org/10.1007/s00261-016-0868-7