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 language | English (US) |
|---|---|
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | Abdominal Radiology |
| DOIs | |
| State | Accepted/In press - Jun 27 2018 |
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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
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 journal › Article
}
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 -