Have an account? Please log in.
Text size: Small font Default font Larger font
.
Radiology Daily
Radiology Daily PracticalReviews.com Radiology Daily

Degree of MRI Enhancement Differentiates Renal Cell Carcinoma Subtypes

December 23, 2009
Written by: , Filed in: Nuclear Medicine
  • Comments
.

The objective of a recent study was to assess whether the enhancement pattern found on MRI is capable of differentiating between clear-cell, papillary, and chromophobe subtypes of RCC.

The results have shown that there are different enhancement patterns which consequently allow differentiation between clear-cell, papillary, and chromophobe renal cell carcinomas (RCCs).

Design
Retrospective analysis.

Participants
Seventy-six men and 36 women with 113 renal masses that had a pathologic diagnosis of RCC.

Methodology
Examinations were performed with 1.5T scanners. Imaging sequences included T2-weighted half-Fourier single-shot fast spin-echo, axial dual-echo T1-weighted in-phase and opposed-phase gradient-echo, and 3-D frequency-selective fat-saturated T1-weighted spoiled gradient-echo performed prior to and during dynamic administration of intravenous gadolinium contrast.

Dynamic acquisitions were obtained during the corticomedullary and nephrographic phases. Region of interest measurements within the neoplasm and the uninvolved renal cortex on precontrast as well as the enhanced-phase images were obtained. Percentage signal intensity change and tumor-to-cortex enhancement index were calculated.

CME Courses Available:

 

PET/CT and SPECT/CT To Plan and Monitor the Treatment of Cancer The precise tailoring of treatment for patients with cancer is an unmet challenge. The goal is to only administer treatments that have a high probability of being effective. Imaging with PET/CT and SPECT/CT provides methods that will help achieve this goal. The program covers the current clinical challenges, the new emerging answers from imaging, and how these methods can be applied to patient care. Read more: Nuclear Medicine: PET/CT and SPECT/CT

 

-- Diagnostic Imaging Review: For Residents, Fellows and Radiologists UCSF’s Department of Radiology and Biomedical Imaging recently conducted its annual radiology review course. It will soon be available in two video formats to meet your needs— DVD and MP4. Order now to get your special pre-publication discount. Read more or order: Diagnostic Imaging Review

Results
The 113 renal masses were confirmed histopathologically via nephrectomy, partial nephrectomy, or biopsy. There were 75 clear-cell, 28 papillary, and 10 chromophobe RCCs. All lesions demonstrated increased signal intensity on the contrast-enhanced images. The mean percentage signal intensity change for all the neoplasms was approximately 154% and 205% during the corticomedullary and nephrographic phases, respectively.

Clear-cell RCCs demonstrated the greatest percentage signal intensity change on the enhanced images, followed by chromophobe and subsequently papillary subtypes. Clear-cell RCCs also demonstrated the largest tumor-to-cortex enhancement index, followed by chromophobe and, subsequently, papillary subtypes.

Clear-cell RCCs demonstrated a decrease in the enhancement index between the corticomedullary and nephrographic phases, while the papillary subtype showed progressive increase in the enhancement index between the two phases.

Therefore, the signal intensity changes on corticomedullary phase images allowed differentiation between clear-cell and papillary RCCs. Utilizing a threshold value of 84%, a 93% sensitivity and a 96% specificity were obtained.

Reviewer’s Comments
The results of this study are useful in that the degree of enhancement on MRI can help differentiate between RCC subtypes–in particular, between the clear-cell and papillary subtypes. Consequently, this information may assist the clinician in outlining an appropriate treatment regimen.

A reported limitation was that this study included only a small number of chromophobe RCCs, which may be in keeping with the overall lower incidence of this subtype.

Author: John C. Sabatino, MD

Reference:
Sun MR, Ngo L, et al. Renal Cell Carcinoma: Dynamic Contrast-Enhanced MR Imaging for Differentiation of Tumor Subtypes — Correlation With Pathologic Findings. Radiology; 2009; 250 (March): 793-802.

CME Courses Available:

 

PET/CT and SPECT/CT To Plan and Monitor the Treatment of Cancer The precise tailoring of treatment for patients with cancer is an unmet challenge. The goal is to only administer treatments that have a high probability of being effective. Imaging with PET/CT and SPECT/CT provides methods that will help achieve this goal. The program covers the current clinical challenges, the new emerging answers from imaging, and how these methods can be applied to patient care. Read more: Nuclear Medicine: PET/CT and SPECT/CT

 

-- Diagnostic Imaging Review: For Residents, Fellows and Radiologists UCSF’s Department of Radiology and Biomedical Imaging recently conducted its annual radiology review course. It will soon be available in two video formats to meet your needs— DVD and MP4. Order now to get your special pre-publication discount. Read more or order: Diagnostic Imaging Review
.

Permalink: http://www.radiologydaily.com/?p=2809

Tags: , , , , , , , , , , , , , , , , , , , , , , ,

  • Comments
.

Would you like to keep current with radiological news and information?

Post Your Comments and Responses

Comments are closed.