Dynamic computed tomography and Doppler findings in different subtypes of renal cell carcinoma with their histopathological correlation

• Published in: Journal of cancer research and therapeutics 2014-07, Vol.10 (3), p.552-557
• Main Authors: Sureka, Binit, Lal, Anupam, Khandelwal, N, Joshi, Kusum, Singh, S K, Agarwal, Mayank M, Mittal, Aliza
• Format: Article
• Language: English
• Subjects: Adult; Aged; Blood clots; Calcinosis; Carcinoma, Renal cell; Carcinoma, Renal Cell - diagnosis; Carcinoma, Renal Cell - pathology; Care and treatment; CT imaging; Diagnosis; Female; Histopathology; Humans; Kidney Neoplasms - diagnosis; Kidney Neoplasms - pathology; Male; Medical imaging; Methods; Middle Aged; NMR; Nuclear magnetic resonance; Prognosis; Tomography; Tomography, X-Ray Computed; Tumor Burden; Tumors; Ultrasonic imaging; Ultrasonography, Doppler; Veins & arteries
• ISSN: 0973-1482; 1998-4138
• DOI: 10.4103/0973-1482.137924

Renal cell carcinoma (RCC) is by far the most common soft-tissue mass and accounts for 85% of all malignant masses of the kidney. Histopathological subtype has clinical implications in the form of prognosis and response to various newer and adjuvant treatment strategies. The aim of this study was to evaluate the morphology and enhancement patterns of different subtypes of RCC and correlate them with their histopathological subtypes. The study group comprised of 20 consecutive patients of RCC. The patients were evaluated with multi-detector-row computed tomography (MDCT) and Doppler ultrasound prior to surgery and findings compared with histopathological subtypes of tumor. RCC was confirmed on histopathology. Out of 20 patients with RCC, 14 were finally diagnosed as clear cell, 4 chromophobe and 2 as papillary subtypes of RCC. None of clear-cell type showed homogenous enhancement. The mean attenuation in corticomedullary phase (CMP) and nephrographic phase (NP) for clear cell and chromophobe subtype was higher than papillary subtype, i.e. 116.1 ± 27 HU and 91.9 ± 21 HU for clear cell, 103 ± 22.4 HU and 96.2 ± 9.2 HU for chromophobe subtype and 78.5 ± 12.4 HU and 73.3 ± 12.2 HU for papillary subtype respectively. On Doppler US evaluation, non-clear-cell subtypes, which showed heterogenous enhancement on MDCT showed less color flow and peak systolic velocity (PSV). The difference in PSV and Doppler shift frequency values between clear-cell carcinoma and chromophobe subtypes were statistically significant (P = 0.003).