Patho-radiological correlation of clear cell renal cancer on double energy twim-beam abdominal computed tomography and biopsy samples
Patho-radiological correlation of clear cell renal cancer on double energy twim-beam abdominal computed tomography and biopsy samples
Camilo G. Sotomayor, Carla Parra, Mariana Garrido, Javiera Núñez, Jorge Hidalgo, Cristian Garrido, Maximiliano Miranda, Juan Casas, Sebastián Yévenes, Álvaro Sanhueza, Francisca Araya, Iván Gallegos, Gonzalo Cárdenas (presenting author))
To investigate the correlation between the histologic index ISUP of renal biopsy samples and imaging features of double energy twim-beam abdominal computed tomography.
Observational, retrospective, and analytical study of consecutive patients with clear cell renal cancer demonstrated by biopsy at our university hospital (2019-2020), and renal cell cancer protocol of abdominal computed tomography with double energy twim-beam portal contrast phase (additionally to arterial and delayed contrast phases) (Figure 1). The association between variables of interest was studied by means of linear regression analyses.
Figure 1. Selected images of double energy twim-beam abdominal computed tomography (A, B) and renal biopsy sample (C, D). (A, B) Anterior cortical hypervascular mass in the middle and lower third of the right kidney (10 x 6 x 12 cms), predominantly exophytic, with an endophytic component that protrudes and widely contacts the collecting system. There is dense content in the most caudal aspect of the renal pelvis, which does not present a significant enhancement in the iodine map. (C, D) Renal parenchyma with development of malignant epithelial neoplasm of configuration in alveolar, papillary, trabecular and solid areas, composed of cells of moderate pleomorphism, from clear to eosinophilic cytoplasm, dense chromatin nucleus and nucleolus in prominent areas.
Eighteen patients (62 ± 9-year-old, 61% male) were studied. ISUP grade showed a normal distribution (Figure 2) as follows: n=1 (ISUP 1), n=8 (ISUP 2), n=6 (ISUP 3), n=3 (ISUP 4). Mean iodine density of regions of interest (segmented lesion) was 3.93 ± 1.31 mg/mL. Higher ISUP grade was inversely associated with lower mean iodine density of regions of interest (standardized beta: -0.76, P<0.001; Figure 3).
Figure 2. Distribution of ISUP grades.
Figure 3. Association between histological grade and mean iodine density (mg/mL).
Among patients with clear cell renal cancer, mean iodine density of regions of interest in double-energy twim-beam portal contrast phase is inversely associated with ISUP grade. Further studies with larger population samples are warranted to investigate whether double energy twim-beam abdominal computed tomography may be proposed to differentiate ISUP grade.
