Clear cell renal cell carcinoma: Identifying the loss of the y chromosome on multiphasic MDCT

Jonathan R Young, Heidi Coy, Michael Douek, Pechin Lo, James Sayre, Allan J. Pantuck, Steven S. Raman

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

OBJECTIVE. The objective of our study was to investigate whether multiphasic MDCT enhancement can help identify clear cell renal cell carcinomas (RCCs) with the loss of the Y chromosome. MATERIALS AND METHODS. We derived a cohort of 43 clear cell RCCs in men who underwent preoperative four-phase renal mass MDCT from October 2000 to August 2013. Each lesion was segmented in its entirety on axial images. 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 ROI was manually placed on uninvolved renal cortex in each phase. The relative attenuation of each lesion was calculated as follows: [(maximal lesion attenuation - cortex attenuation) / cortex attenuation] × 100. Absolute attenuation and relative attenuation in each phase were compared using t tests. RESULTS. Both clear cell RCCs with the loss of the Y chromosome and clear cell RCCs without the loss of the Y chromosome exhibited peak enhancement in the corticomedullary phase. However, relative nephrographic attenuation of clear cell RCCs with the loss of Y was significantly less than that of clear cell RCCs without the loss of Y (mean, -8.9 vs 8.4 respectively; p = 0.013). A relative nephrographic attenuation threshold of -1.6 identified the loss of Y with an accuracy of 70% (30/43), sensitivity of 73% (16/22), and specificity of 67% (14/21). CONCLUSION. Multiphasic MDCT enhancement may assist in identifying the loss of the Y chromosome in clear cell RCCs; this result should be validated in a large prospective trial.

Original languageEnglish (US)
Pages (from-to)333-338
Number of pages6
JournalAmerican Journal of Roentgenology
Volume209
Issue number2
DOIs
StatePublished - Aug 1 2017
Externally publishedYes

Keywords

  • Clear cell renal cell carcinoma
  • Cytogenetics
  • MDCT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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