Thursday, May 16, 2013

Clear Cell Renal Cell Carcinoma: Discrimination from Other Renal Cell Carcinoma Subtypes and Oncocytoma at Multiphasic Multidetector CT



The use of multiphasic CT scan may assist in characterizing renal lesions, especially discriminating some subtypes of renal cell carcinoma (RCC) from oncocytoma.  Young et al demonstrated that oncocytomas have peak enhancement in the corticomedullary phase with an average density of 106 Hu.  Clear cell RCC enhancement also peaks in the corticomedullary phase, however their enhancement is higher than oncocytomas with an average of 125 Hu (p=0.045).  The accuracy for discriminating these lesions was 77%.  Chromophobe and papillary RCCs have peak enhancement in the nephrographic phase.  Their average corticomedullary enhancement is 74 Hu and 54 Hu respectively.  

PICO analysis
P- 298 lesions in 274 patients with an average age of 62 (23-87)
I- Retrospective analysis of enhancement characteristics of renal lesions on multiphasic CT
C- Biopsy, partial nephrectomy, and full nephrectomy results
O-Differentiating renal lesions: Subtypes of RCC versus oncocytomas

Radiology, Volume 267: Number 2, May 2013
Links: PubmedFull text

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