Clear cell renal cell carcinoma

Multiphasic MDCT enhancement can predict the loss of chromosome 8p

Jonathan R Young, Daniel Margolis, Steven Sauk, Allan J. Pantuck, James Sayre, Jocelyn A. Young, Margaret Hsu, Steven S. Raman

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: To investigate whether imaging features on multiphasic multidetector computed tomography (MDCT) can predict the loss of chromosome 8p in clear cell renal cell carcinomas (RCCs), a cytogenetic abnormality associated with a higher tumor grade and greater risk of recurrence. Methods: With IRB approval for this HIPAA-compliant retrospective study, we queried our institution's pathology database to derive all histologically proven cases of clear cell RCC with preoperative multiphasic MDCT with as many as four phases (unenhanced, corticomedullary, nephrographic, and excretory) from January 2000 to July 2010. Of 170 clear cell RCCs with preoperative multiphasic MDCT, 105 clear cell RCCs, representing 98 unique patients, had karyotypes of the resected specimens. Lesions were evaluated for magnitude and pattern of enhancement, contour, neovascularity, calcifications, and size. Results: The corticomedullary phase mean enhancement of clear cell RCCs with a loss of 8p was significantly greater than that of clear cell RCCs without a loss of 8p (169.5 vs. 127.2 HU, p = 0.004). A threshold of 165 HU predicted the loss of 8p in clear cell RCCs with an accuracy of 78% (69/88), a specificity of 81% (62/77), and a negative predictive value of 94% (62/66). There were no significant differences in the pattern of enhancement, contour, neovascularity, calcification, or size between clear cell RCCs with a loss of 8p and those without this abnormality. Conclusion: Enhancement on multiphasic MDCT can predict the loss of 8p in clear cell RCCs and can thus provide a non-invasive means of guiding further management, including surgery, ablation, watchful waiting, or medical management.

Original languageEnglish (US)
Pages (from-to)543-549
Number of pages7
JournalAbdominal Imaging
Volume39
Issue number3
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Multidetector Computed Tomography
Renal Cell Carcinoma
Chromosomes
Watchful Waiting
Health Insurance Portability and Accountability Act
Research Ethics Committees
Karyotype
Chromosome Aberrations
Retrospective Studies
Databases
Pathology
Recurrence

Keywords

  • Clear cell renal cell carcinoma
  • Cytogenetics
  • Multiphasic multidetector computed tomography

ASJC Scopus subject areas

  • Gastroenterology
  • Urology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Medicine(all)

Cite this

Clear cell renal cell carcinoma : Multiphasic MDCT enhancement can predict the loss of chromosome 8p. / Young, Jonathan R; Margolis, Daniel; Sauk, Steven; Pantuck, Allan J.; Sayre, James; Young, Jocelyn A.; Hsu, Margaret; Raman, Steven S.

In: Abdominal Imaging, Vol. 39, No. 3, 01.01.2014, p. 543-549.

Research output: Contribution to journalArticle

Young, JR, Margolis, D, Sauk, S, Pantuck, AJ, Sayre, J, Young, JA, Hsu, M & Raman, SS 2014, 'Clear cell renal cell carcinoma: Multiphasic MDCT enhancement can predict the loss of chromosome 8p', Abdominal Imaging, vol. 39, no. 3, pp. 543-549. https://doi.org/10.1007/s00261-014-0092-2
Young, Jonathan R ; Margolis, Daniel ; Sauk, Steven ; Pantuck, Allan J. ; Sayre, James ; Young, Jocelyn A. ; Hsu, Margaret ; Raman, Steven S. / Clear cell renal cell carcinoma : Multiphasic MDCT enhancement can predict the loss of chromosome 8p. In: Abdominal Imaging. 2014 ; Vol. 39, No. 3. pp. 543-549.
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AU - Margolis, Daniel

AU - Sauk, Steven

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AU - Sayre, James

AU - Young, Jocelyn A.

AU - Hsu, Margaret

AU - Raman, Steven S.

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N2 - Purpose: To investigate whether imaging features on multiphasic multidetector computed tomography (MDCT) can predict the loss of chromosome 8p in clear cell renal cell carcinomas (RCCs), a cytogenetic abnormality associated with a higher tumor grade and greater risk of recurrence. Methods: With IRB approval for this HIPAA-compliant retrospective study, we queried our institution's pathology database to derive all histologically proven cases of clear cell RCC with preoperative multiphasic MDCT with as many as four phases (unenhanced, corticomedullary, nephrographic, and excretory) from January 2000 to July 2010. Of 170 clear cell RCCs with preoperative multiphasic MDCT, 105 clear cell RCCs, representing 98 unique patients, had karyotypes of the resected specimens. Lesions were evaluated for magnitude and pattern of enhancement, contour, neovascularity, calcifications, and size. Results: The corticomedullary phase mean enhancement of clear cell RCCs with a loss of 8p was significantly greater than that of clear cell RCCs without a loss of 8p (169.5 vs. 127.2 HU, p = 0.004). A threshold of 165 HU predicted the loss of 8p in clear cell RCCs with an accuracy of 78% (69/88), a specificity of 81% (62/77), and a negative predictive value of 94% (62/66). There were no significant differences in the pattern of enhancement, contour, neovascularity, calcification, or size between clear cell RCCs with a loss of 8p and those without this abnormality. Conclusion: Enhancement on multiphasic MDCT can predict the loss of 8p in clear cell RCCs and can thus provide a non-invasive means of guiding further management, including surgery, ablation, watchful waiting, or medical management.

AB - Purpose: To investigate whether imaging features on multiphasic multidetector computed tomography (MDCT) can predict the loss of chromosome 8p in clear cell renal cell carcinomas (RCCs), a cytogenetic abnormality associated with a higher tumor grade and greater risk of recurrence. Methods: With IRB approval for this HIPAA-compliant retrospective study, we queried our institution's pathology database to derive all histologically proven cases of clear cell RCC with preoperative multiphasic MDCT with as many as four phases (unenhanced, corticomedullary, nephrographic, and excretory) from January 2000 to July 2010. Of 170 clear cell RCCs with preoperative multiphasic MDCT, 105 clear cell RCCs, representing 98 unique patients, had karyotypes of the resected specimens. Lesions were evaluated for magnitude and pattern of enhancement, contour, neovascularity, calcifications, and size. Results: The corticomedullary phase mean enhancement of clear cell RCCs with a loss of 8p was significantly greater than that of clear cell RCCs without a loss of 8p (169.5 vs. 127.2 HU, p = 0.004). A threshold of 165 HU predicted the loss of 8p in clear cell RCCs with an accuracy of 78% (69/88), a specificity of 81% (62/77), and a negative predictive value of 94% (62/66). There were no significant differences in the pattern of enhancement, contour, neovascularity, calcification, or size between clear cell RCCs with a loss of 8p and those without this abnormality. Conclusion: Enhancement on multiphasic MDCT can predict the loss of 8p in clear cell RCCs and can thus provide a non-invasive means of guiding further management, including surgery, ablation, watchful waiting, or medical management.

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