Renal Cell Carcinoma: Role of CT scans in discrimination of histological subtypes

Congress:

ECR 2020

Poster Number:

C-07380

Type:

Scientific Exhibit

Keywords:

Performed at one institution, Observational, Retrospective, Pathology, Neoplasia, Education, Comparative studies, CT, Oncology, Kidney, Genitourinary

Authors:

B. Giesteira¹, J. Carvalho¹, M. A. Rocha¹, J. Sousa¹, E. M. Abreu¹, M. França²; ¹Porto/PT, ²Maia/PT

DOI:

10.26044/ecr2020/C-07380

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-07380

Table 1: Characteristics of patients and renal lesions. Note - RCC: renal cell...

Table 2: Attenuation of renal lesions on the basis of histologic subtype: clear cell RCC...

Table 3: Attenuation of renal lesions on the basis of histologic subtype: clear cell RCC...

Table 4: Attenuation of renal lesions on the basis of histologic subtype: papillary...

Table 5: Presence of calcifications, perinephric fat invasion, venous infiltration and...

Results

Lesions (Table 1)

Inclusion of 86 RCC lesions - 53 clear cell (61.6%), 21 papillary (24.4%) and 12 chromophobe RCC (14%).

All groups were more common in males, with similar gender distribution between them (p=0.26).

No statistical difference was found for age of diagnosis (p=0.37) and laterality (p=0.49).

Lesion size was similar for all the subtypes (p=0.38).

Pattern of enhancement (Tables 2, 3, 4)

Forty-seven clear cell (88.7%), five papillary (23.8%) and nine chromophobe RCC (75%) showed heterogeneous enhancement. Statistical difference was only found comparing clear cell and papillary groups (p<0.01).

Peak enhancement phase (Tables 2, 3, 4)

Twenty-nine clear cell (90.6%) RCC peaked at corticomedullary phase, but fifteen papillary (83.3%) and six chromophobe (54.5%) RCC peaked at nephrographic phase. Statistical difference was only found between clear cell and papillary RCC (p<0.01).

Calcifications (Table 5)

Forty-seven (88.7%), twenty (95.2%) and nine (75%) of clear cell, papillary and chromophobe RCC, respectively, did not have intralesional calcifications. No differences were found comparing them (p=0.5).

Perinephric, vascular and lymphatic invasion (Table 5)

Perinephric invasion was present in five clear cell (17%) RCC and one papillary (4.8%) RCC. Vascular invasion was only present in 6 clear cell RCC (11.3%). Lymphadenophaty was present in three clear cell (5.6%) and in one papillary RCC (4.8%).

Chromophobe RCC showed absence of perinephric, vascular or lymphatic involvement.

For these parameters no statistical significant difference was found between the groups (p=0.17; p=0.11; p=0.88, respectively).

Magnitude of enhancement (Tables 2, 3, 4)

Density of RCC subtypes, measured in Housefield Units (HU), was similar on unenhanced scans (p=0.4).

- Corticomedullary phase: The enhancement was higher for clear cell (143HU) when compared to papillary (56HU) and chromophobe RCC (112HU),(p<0.01; p=0.03, respectively). Statistical difference was also found between papillary and chromophobe groups (p<0.01).

- Nephrographic phase: The enhancement was higher for clear cell (111HU) than for papillary RCC (69HU), (p<0.01). Differences were also found between papillary and chromophobe RCC (105 HU), (p<0.01).

- Excretory phase: difference on the enhancement was only found comparing clear cell RCC (81HU) and papillary RCC (60HU), (p<0.01).