Clear cell renal cell carcinoma: identifying PTEN expression on multiphasic MDCT

Jonathan R Young, Heidi Coy, Hyun J. Kim, Michael Douek, Anthony Sisk, Allan J. Pantuck, Steven S. Raman

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate whether multiphasic MDCT enhancement profiles can help to identify PTEN expression in clear cell renal cell carcinomas (ccRCCs). Lack of PTEN expression is associated with worsened overall survival, a more advanced Fuhrman grade, and a greater likelihood of lymph mode metastasis. Methods: With IRB approval for this retrospective study, we derived a cohort of 103 histologically proven ccRCCs with preoperative 4-phase renal mass MDCT from 2001–2013. Following manual segmentation, a computer-assisted detection algorithm selected a 0.5-cm-diameter region of maximal attenuation within each lesion in each phase; a 0.5-cm-diameter region of interest was manually placed on uninvolved renal cortex in each phase. The relative attenuation of each lesion was calculated as [(Maximal lesion attenuation − cortex attenuation)/cortex attenuation] × 100. Absolute and relative attenuation in each phase were compared using t tests. The performance of multiphasic enhancement in identifying PTEN expression was assessed with logistic regression analysis. Results: PTEN-positive and PTEN-negative ccRCCs both exhibited peak enhancement in the corticomedullary phase. Relative corticomedullary phase attenuation was significantly greater for PTEN-negative ccRCCs in comparison to PTEN-positive ccRCCs (33.7 vs. 9.5, p = 0.03). After controlling for lesion stage and size, relative corticomedullary phase attenuation had an accuracy of 84% (86/103), specificity of 100% (84/84), sensitivity of 11% (2/19), positive predictive value of 100% (2/2), and negative predictive value of 83% (84/101) in identifying PTEN expression. Conclusion: Relative corticomedullary phase attenuation may help to identify PTEN expression in ccRCCs, if validated prospectively.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Jun 27 2018

Fingerprint

Renal Cell Carcinoma
Kidney
Research Ethics Committees
Lymph
Retrospective Studies
Logistic Models
Regression Analysis
Neoplasm Metastasis

Keywords

  • Clear cell renal cell carcinoma
  • Multidetector computed tomography
  • PTEN
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

Young, J. R., Coy, H., Kim, H. J., Douek, M., Sisk, A., Pantuck, A. J., & Raman, S. S. (Accepted/In press). Clear cell renal cell carcinoma: identifying PTEN expression on multiphasic MDCT. Abdominal Radiology, 1-8. https://doi.org/10.1007/s00261-018-1672-3

Clear cell renal cell carcinoma : identifying PTEN expression on multiphasic MDCT. / Young, Jonathan R; Coy, Heidi; Kim, Hyun J.; Douek, Michael; Sisk, Anthony; Pantuck, Allan J.; Raman, Steven S.

In: Abdominal Radiology, 27.06.2018, p. 1-8.

Research output: Contribution to journalArticle

Young, Jonathan R ; Coy, Heidi ; Kim, Hyun J. ; Douek, Michael ; Sisk, Anthony ; Pantuck, Allan J. ; Raman, Steven S. / Clear cell renal cell carcinoma : identifying PTEN expression on multiphasic MDCT. In: Abdominal Radiology. 2018 ; pp. 1-8.
@article{8da95f71a9ce4c03ae3612bbfca78b8a,
title = "Clear cell renal cell carcinoma: identifying PTEN expression on multiphasic MDCT",
abstract = "Purpose: To investigate whether multiphasic MDCT enhancement profiles can help to identify PTEN expression in clear cell renal cell carcinomas (ccRCCs). Lack of PTEN expression is associated with worsened overall survival, a more advanced Fuhrman grade, and a greater likelihood of lymph mode metastasis. Methods: With IRB approval for this retrospective study, we derived a cohort of 103 histologically proven ccRCCs with preoperative 4-phase renal mass MDCT from 2001–2013. Following manual segmentation, a computer-assisted detection algorithm selected a 0.5-cm-diameter region of maximal attenuation within each lesion in each phase; a 0.5-cm-diameter region of interest was manually placed on uninvolved renal cortex in each phase. The relative attenuation of each lesion was calculated as [(Maximal lesion attenuation − cortex attenuation)/cortex attenuation] × 100. Absolute and relative attenuation in each phase were compared using t tests. The performance of multiphasic enhancement in identifying PTEN expression was assessed with logistic regression analysis. Results: PTEN-positive and PTEN-negative ccRCCs both exhibited peak enhancement in the corticomedullary phase. Relative corticomedullary phase attenuation was significantly greater for PTEN-negative ccRCCs in comparison to PTEN-positive ccRCCs (33.7 vs. 9.5, p = 0.03). After controlling for lesion stage and size, relative corticomedullary phase attenuation had an accuracy of 84{\%} (86/103), specificity of 100{\%} (84/84), sensitivity of 11{\%} (2/19), positive predictive value of 100{\%} (2/2), and negative predictive value of 83{\%} (84/101) in identifying PTEN expression. Conclusion: Relative corticomedullary phase attenuation may help to identify PTEN expression in ccRCCs, if validated prospectively.",
keywords = "Clear cell renal cell carcinoma, Multidetector computed tomography, PTEN, Renal cell carcinoma",
author = "Young, {Jonathan R} and Heidi Coy and Kim, {Hyun J.} and Michael Douek and Anthony Sisk and Pantuck, {Allan J.} and Raman, {Steven S.}",
year = "2018",
month = "6",
day = "27",
doi = "10.1007/s00261-018-1672-3",
language = "English (US)",
pages = "1--8",
journal = "Abdominal Radiology",
issn = "2366-004X",
publisher = "Springer New York",

}

TY - JOUR

T1 - Clear cell renal cell carcinoma

T2 - identifying PTEN expression on multiphasic MDCT

AU - Young, Jonathan R

AU - Coy, Heidi

AU - Kim, Hyun J.

AU - Douek, Michael

AU - Sisk, Anthony

AU - Pantuck, Allan J.

AU - Raman, Steven S.

PY - 2018/6/27

Y1 - 2018/6/27

N2 - Purpose: To investigate whether multiphasic MDCT enhancement profiles can help to identify PTEN expression in clear cell renal cell carcinomas (ccRCCs). Lack of PTEN expression is associated with worsened overall survival, a more advanced Fuhrman grade, and a greater likelihood of lymph mode metastasis. Methods: With IRB approval for this retrospective study, we derived a cohort of 103 histologically proven ccRCCs with preoperative 4-phase renal mass MDCT from 2001–2013. Following manual segmentation, a computer-assisted detection algorithm selected a 0.5-cm-diameter region of maximal attenuation within each lesion in each phase; a 0.5-cm-diameter region of interest was manually placed on uninvolved renal cortex in each phase. The relative attenuation of each lesion was calculated as [(Maximal lesion attenuation − cortex attenuation)/cortex attenuation] × 100. Absolute and relative attenuation in each phase were compared using t tests. The performance of multiphasic enhancement in identifying PTEN expression was assessed with logistic regression analysis. Results: PTEN-positive and PTEN-negative ccRCCs both exhibited peak enhancement in the corticomedullary phase. Relative corticomedullary phase attenuation was significantly greater for PTEN-negative ccRCCs in comparison to PTEN-positive ccRCCs (33.7 vs. 9.5, p = 0.03). After controlling for lesion stage and size, relative corticomedullary phase attenuation had an accuracy of 84% (86/103), specificity of 100% (84/84), sensitivity of 11% (2/19), positive predictive value of 100% (2/2), and negative predictive value of 83% (84/101) in identifying PTEN expression. Conclusion: Relative corticomedullary phase attenuation may help to identify PTEN expression in ccRCCs, if validated prospectively.

AB - Purpose: To investigate whether multiphasic MDCT enhancement profiles can help to identify PTEN expression in clear cell renal cell carcinomas (ccRCCs). Lack of PTEN expression is associated with worsened overall survival, a more advanced Fuhrman grade, and a greater likelihood of lymph mode metastasis. Methods: With IRB approval for this retrospective study, we derived a cohort of 103 histologically proven ccRCCs with preoperative 4-phase renal mass MDCT from 2001–2013. Following manual segmentation, a computer-assisted detection algorithm selected a 0.5-cm-diameter region of maximal attenuation within each lesion in each phase; a 0.5-cm-diameter region of interest was manually placed on uninvolved renal cortex in each phase. The relative attenuation of each lesion was calculated as [(Maximal lesion attenuation − cortex attenuation)/cortex attenuation] × 100. Absolute and relative attenuation in each phase were compared using t tests. The performance of multiphasic enhancement in identifying PTEN expression was assessed with logistic regression analysis. Results: PTEN-positive and PTEN-negative ccRCCs both exhibited peak enhancement in the corticomedullary phase. Relative corticomedullary phase attenuation was significantly greater for PTEN-negative ccRCCs in comparison to PTEN-positive ccRCCs (33.7 vs. 9.5, p = 0.03). After controlling for lesion stage and size, relative corticomedullary phase attenuation had an accuracy of 84% (86/103), specificity of 100% (84/84), sensitivity of 11% (2/19), positive predictive value of 100% (2/2), and negative predictive value of 83% (84/101) in identifying PTEN expression. Conclusion: Relative corticomedullary phase attenuation may help to identify PTEN expression in ccRCCs, if validated prospectively.

KW - Clear cell renal cell carcinoma

KW - Multidetector computed tomography

KW - PTEN

KW - Renal cell carcinoma

UR - http://www.scopus.com/inward/record.url?scp=85049061585&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85049061585&partnerID=8YFLogxK

U2 - 10.1007/s00261-018-1672-3

DO - 10.1007/s00261-018-1672-3

M3 - Article

C2 - 29946925

AN - SCOPUS:85049061585

SP - 1

EP - 8

JO - Abdominal Radiology

JF - Abdominal Radiology

SN - 2366-004X

ER -