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.
Similar content being viewed by others
References
Cohen HT, McGovern FJ (2005) Renal-cell carcinoma. N Engl J Med 353:2477–2490.
Klatte T, Rao PN, de Martino M, et al. (2009) Cytogenetic profile predicts prognosis of patients with clear cell renal cell carcinoma. J Clin Oncol 27:746–753.
Presti JC Jr, Wilhelm M, Reuter V, et al. (2002) Allelic loss on chromosomes 8 and 9 correlates with clinical outcome in locally advanced clear cell carcinoma of the kidney. J Urol 167:1464–1468.
Elfving P, Mandahl N, Lundgren R, et al. (1997) Prognostic implications of cytogenetic findings in kidney cancer. Br J Urol 80:698–706.
Schullerus D, Herbers J, Chudek J, Kanamaru H, Kovacs G (1997) Loss of heterozygosity at chromosomes 8p, 9p, and 14q is associated with stage and grade of non-papillary renal cell carcinomas. J Pathol 183:151–155.
Cheng L, Zhang S, MacLennan GT, Lopez-Beltran A, Montironi R (2009) Molecular and cytogenetic insights into the pathogenesis, classification, differential diagnosis, and prognosis of renal epithelial neoplasms. Hum Pathol 40:10–29.
Young JR, Margolis D, Sauk S, et al. (2013) Clear cell renal cell carcinoma: discrimination from other renal cell carcinoma subtypes and oncocytoma at multiphasic multidetector CT. Radiology 267:444–453.
Zhang J, Lefkowitz RA, Ishill NM, et al. (2007) Solid renal cortical tumors: differentiation with CT. Radiology 244:494–504.
Sheir KZ, El-Azab M, Mosbah A, El-Baz M, Shaaban AA (2005) Differentiation of renal cell carcinoma subtypes by multislice computerized tomography. J Urol 174:451–455; discussion 5.
Kim JK, Kim TK, Ahn HJ, et al. (2002) Differentiation of subtypes of renal cell carcinoma on helical CT scans. AJR Am J Roentgenol 178:1499–1506.
Jinzaki M, Tanimoto A, Mukai M, et al. (2000) Double-phase helical CT of small renal parenchymal neoplasms: correlation with pathologic findings and tumor angiogenesis. J Comput Assist Tomogr 24:835–842.
Ruppert-Kohlmayr AJ, Uggowitzer M, Meissnitzer T, Ruppert G (2004) Differentiation of renal clear cell carcinoma and renal papillary carcinoma using quantitative CT enhancement parameters. AJR Am J Roentgenol 183:1387–1391.
Sauk SC, Hsu MS, Margolis DJ, et al. (2011) Clear cell renal cell carcinoma: multiphasic multidetector CT imaging features help predict genetic karyotypes. Radiology 261:854–862.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Young, J.R., Margolis, D., Sauk, S. et al. Clear cell renal cell carcinoma: multiphasic MDCT enhancement can predict the loss of chromosome 8p. Abdom Imaging 39, 543–549 (2014). https://doi.org/10.1007/s00261-014-0092-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-014-0092-2