ISSN 1004-4140
CN 11-3017/P
| Citation: |
ZHANG X J, ZHAI J, ZHANG H, et al. Prediction of WHO/ISUP Grading of Renal Clear Cell Carcinoma by Quantitative Parameters of CT Enhancement Scanning[J]. CT Theory and Applications, 2023, 32(6): 746-752. DOI: 10.15953/j.ctta.2022.253. (in Chinese).
|
Objective: To investigate the potential of CT-enhanced quantitative parameters for preoperative prediction of WHO/ISUP grading for renal clear cell carcinoma (ccRCC). Methods: The study involved collecting clinical and CT-enhanced data of 98 patients with ccRCC, who were then classified into low level group (76 cases) and high level group (22 cases) based on the WHO/ISUP classification. Differences in CT-enhanced quantitative parameters between the two groups were compared, and the diagnostic efficacy of each parameter for predicting ccRCC WHO/ISUP grading was evaluated. External verification was conducted to identify CT-enhanced quantitative parameters with the best generalization ability. Results: There were significant differences in the CT value, net increment, and enhancement rate in both cortical and substantive phases between the two groups. The AUC values were 0.834, 0.871, 0.900, 0.707, 0.678, and 0.762, respectively. The cut-off values were 123.5 HU, 71 HU, 0.73, 87.5 HU, 54 HU, 0.67, respectively. The diagnostic efficacy of cortical enhancement rate was the highest with an AUC of 0.900, a sensitivity of 0.842, and a specificity of 0.864. The external validation results revealed that the diagnostic efficacy of cortical phase enhancement rate (AUC=0.867) was better than that of cortical phase CT (AUC=0.735) and cortical phase net increment (AUC=0.709). The Z values were 2.134 and 2.417, respectively. Conclusion: The quantitative parameters of CT enhancement can be used to predict ccRCC WHO/ISUP grading. Cortical phase enhancement rate is the parameter with the highest diagnostic efficiency and the best generalization ability.
| [1] |
SHEELA DEVI C S, SUCHITHA S, VEERENDRASAGAR R S. Evaluation of nuclear morphometry and ki-67 index in clear cell renal cell carcinomas: A five-year study[J]. Iranian Journal of Pathology, 2017, 12(2): 150−157. doi: 10.30699/ijp.2017.24873
|
| [2] |
MOCH H, CUBILLA A L, HUMPHREY P A, et al. The 2016 WHO classification of tumours of the urinary system and male genital organs-part a: Renal, penile, and testicular tumours[J]. European Urology, 2016, 70(1): 93−105. doi: 10.1016/j.eururo.2016.02.029
|
| [3] |
DELAHUNT B, EBLE J N, EGEVAD L, et al. Grading of renal cell carcinoma[J]. Histopathology, 2019, 74(1): 4−17. doi: 10.1111/his.13735
|
| [4] |
张涛, 汪建文, 陈立芳. 肾透明细胞癌多排螺旋CT影像表现与Fuhrman分级的相关性分析[J]. 安徽医药, 2020,24(6): 1192−1194.
ZHANG T, WANG J W, CHEN L F. Correlation analysis of the relationship between MDCT feature and Fuhrman grading in 40 patients with clear cell renal cell carcinoma[J]. Anhui Medical and Pharmaceutical Journal, 2020, 24(6): 1192−1194. (in Chinese).
|
| [5] |
ZHU Y H, WANG X, ZHANG J, et al. Low enhancement on multiphase contrast-enhanced CT images: An independent predictor of the presence of high tumor grade of clear cell renal cell carcinoma[J]. American Journal of Roentgenology, 2014, 203(3): 295−300. doi: 10.2214/AJR.13.12297
|
| [6] |
高杨, 陈炜越, 陈春妙, 等. 肾透明细胞癌的CT特征与其侵袭性的相关性研究[J]. 中国中西医结合影像学杂志, 2022,20(3): 250−254, 258.
GAO Y, CHEN W Y, CHEN C M, et al. CT features of clear cell renal cell carcinoma and its correlation with the invasiveness[J]. Chinese Imaging Journal of Integrated Traditional and Western Medicine, 2022, 20(3): 250−254, 258. (in Chinese).
|
| [7] |
DAGHER J, DELAHUNT B, RIOUX-LECLERCQ N, et al. Clear cell renal cell carcinoma: Validation of World Health Organization/International Society of Urological Pathology Grading[J]. Histopathology, 2017, 71(6): 918−925.
|
| [8] |
张庆林, 庄梅香, 罗雪萍. 增强CT参数在鉴别肾脏良恶性肿瘤中的初步研究[J]. 影像科学与光化学, 2021,39(6): 845−848. doi: 10.7517/issn.1674-0475.210505
ZHANG Q L, ZHUANG M X, LUO X P. Preliminary study of enhanced CT parameters in differential diagnosis of benign and malignant renal tumors[J]. Imaging Science and Photochemistry, 2021, 39(6): 845−848. (in Chinese). doi: 10.7517/issn.1674-0475.210505
|
| [9] |
陈天昱, 樊树峰. Fisher判别模型在肾透明细胞癌多层螺旋CT征像及病理学WHO/ISUP分级中的价值[J]. 浙江医学, 2021,43(7): 753−756, 774. doi: 10.12056/j.issn.1006-2785.2021.43.7.2020-2256
CHEN T Y, FAN S F. Establishment of a Fisher discriminant model for preoperative grading of renal clear cell carcinoma based on MSCT features and WHO/ISUP classification[J]. Zhejiang Medicine, 2021, 43(7): 753−756, 774. (in Chinese). doi: 10.12056/j.issn.1006-2785.2021.43.7.2020-2256
|
| [10] |
刘阳, 朱丽, 李建春, 等. 肾透明细胞癌WHO/ISUP分级的超声预测因素分析[J]. 中华医学超声杂志(电子版), 2021,18(6): 605−610.
LIU Y, ZHU L, LI J C, et al. Ultrasonic predictors of WHO/ISUP classification of clear cell renal cell carcinoma[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(6): 605−610. (in Chinese).
|
| [11] |
GAO J, XU Q, FU Y, et al. Comprehensive evaluation of 68 Ga-PSMA-11 PET/CT parameters for discriminating pathological characteristics in primary clear-cell renal cell carcinoma[J]. European Journal of Nuclear Medicine and Molecular Imaging, 2021, 48(2): 561−569. doi: 10.1007/s00259-020-04916-6
|
| [12] |
WANG X, SONG G, JIANG H, et al. Can texture analysis based on single unenhanced CT accurately predict the WHO/ISUP grading of localized clear cell renal cell carcinoma?[J]. Abdominal Radiology, 2021, 46(9): 4289−4300. doi: 10.1007/s00261-021-03090-z
|
| [13] |
顾长青, 李陆, 孙冬雪, 等. 影像组学诺模图在术前预测肾透明细胞癌WHO/ISUP分级的应用研究[J]. 临床放射学杂志, 2022,41(10): 1915−1920.
GU C Q, LI L, SUN D X, et al. Application of radiomic nomogram in preoperative prediction of WHO/ISUP grade of renal clear cell carcinoma[J]. Journal of Clinical Radiology, 2022, 41(10): 1915−1920. (in Chinese).
|
| [14] |
MA Y, GUAN Z, LIANG H, et al. Predicting the WHO/ISUP grade of clear cell renal cell carcinoma through CT-based tumoral and peritumoral radiomics[J]. Front Oncol, 2022, 12: 831112.
|
| [15] |
MAYER P, FRITZ F, KOELL M, et al. Assessment of tissue perfusion of pancreatic cancer as potential imaging biomarker by means of Intravoxel incoherent motion MRI and CT perfusion: Correlation with histological microvessel density as ground truth[J]. Cancer Imaging, 2021, 21(1): 13.
|
| [16] |
SENGUPTA S, LOHSE C M, LEIBOVICH B C, et al. Histologic coagulative tumor necrosis as a prog-nostic indicator of renal cell carcinoma aggressiveness[J]. Cancer, 2005, 104(3): 511−520. doi: 10.1002/cncr.21206
|
| [17] |
IANNESSI A, BEAUMONT H, HEBERT C, et al. Computer tomography-based body surface area evaluation for drug dosage: Quantitative radiology versus anthropomorphic evaluation[J]. The Public Library of Science, 2018, 13(2): e0192124.
|
| [18] |
赵文敬, 郭君武. 低浓度低剂量对比剂结合高注射流率在肠系膜上动脉CTA中的应用[J]. 中国中西医结合影像学杂志, 2020,18(1): 87−90.
ZHAO W J, GUO J W. Application of a low dose of contrast media combined with high injection rate to superior mesenteric artery CTA[J]. Chinese Imaging Journal of Integrated Traditional and Western Medicine, 2020, 18(1): 87−90. (in Chinese).
|
| 1. |
赖小珍，邓玲玲. 比较MRI与CT检查对肝脏孤立性结节鉴别的诊断价值. 现代诊断与治疗. 2024(13): 1976-1977+1980 .
|
Supported by: Beijing Renhe Information Technology Co. Ltd 
DownLoad: