scholarly journals Diagnostic Potential of Multidetector Computed Tomography for Characterizing Small Renal Masses

2015 ◽  
Vol 2015 ◽  
pp. 1-8
Author(s):  
Maria Elisabetta Mancini ◽  
Annamaria Albergo ◽  
Marco Moschetta ◽  
Mariacristina Angelelli ◽  
Arnaldo Scardapane ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Clear Cell ◽  
Renal Tumors ◽  
Arterial Phase ◽  
Renal Masses ◽  
Portal Phase ◽  
Diagnostic Potential ◽  
Peak Enhancement ◽  
Density Values ◽  
Delayed Phase

Objectives. To assess the potential of CT for characterizing small renal tumors.Methods. 76 patients with <4 cm renal tumors underwent CT examination. The following parameters were assessed: presence of calcifications, densitometry on unenhanced and enhanced scans, washout percentage, urinary tract infiltration, star-shaped scar, and paradoxical effect.Results. Calcifications were found in 7/56 (12.5%) carcinomas. Clear cell carcinomas were as follows: mean density 183.5 HU (arterial phase), 136 HU (portal phase), and 94 HU (delayed phase), washout 34.3%; chromophobe carcinomas were as follows: mean density 135 HU (arterial phase), 161 HU (portal phase), and 148 HU (delayed phase), washout 28%; papillary carcinomas were as follows: mean density 50.3 HU (arterial phase), 60 HU (portal phase), and 58.1 HU (delayed phase), washout 2.7%. In 2/56 (3.6%) cases urinary tract infiltration was found. Oncocytomas were as follows: mean density 126.5 HU (arterial phase), 147.5 HU (portal phase), and 115.5 HU (delayed phase), washout 28.6%. On unenhanced scans, angiomyolipomas were as follows: density values <30 HU in 12/12 (100%) of cases and on enhanced scans: mean density 78 HU (arterial phase), 128 HU (portal phase), and 80 HU (delayed phase), washout 50%.Conclusions. Intralesional calcifications and urinary tract infiltration are suggestive for malignancy, with the evidence of adipose tissue for angiomyolipomas and a modest increase in density with a reduced washout for papillary carcinomas. The intralesional density on enhanced scans, peak enhancement, and washout do not seem significant for differentiating clear cell, chromophobe carcinomas, angiomyolipomas, and oncocytomas.

scholarly journals Differentiation of Clear Cell Renal Cell Carcinoma from other Renal Cell Carcinoma Subtypes and Benign Oncocytoma Using Quantitative MDCT Enhancement Parameters

Medicina ◽  
2020 ◽  
Vol 56 (11) ◽  
pp. 569
Author(s):  
Claudia-Gabriela Moldovanu ◽  
Bianca Petresc ◽  
Andrei Lebovici ◽  
Attila Tamas-Szora ◽  
Mihai Suciu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Renal Tumors ◽  
3D Analysis ◽  
Imaging Features ◽  
Enhancement Ratio ◽  
Cell Renal Cell Carcinoma ◽  
Renal Masses

Background and objectives: The use of non-invasive techniques to predict the histological type of renal masses can avoid a renal mass biopsy, thus being of great clinical interest. The aim of our study was to assess if quantitative multiphasic multidetector computed tomography (MDCT) enhancement patterns of renal masses (malignant and benign) may be useful to enable lesion differentiation by their enhancement characteristics. Materials and Methods: A total of 154 renal tumors were retrospectively analyzed with a four-phase MDCT protocol. We studied attenuation values using the values within the most avidly enhancing portion of the tumor (2D analysis) and within the whole tumor volume (3D analysis). A region of interest (ROI) was also placed in the adjacent uninvolved renal cortex to calculate the relative tumor enhancement ratio. Results: Significant differences were noted in enhancement and de-enhancement (diminution of attenuation measurements between the postcontrast phases) values by histology. The highest areas under the receiver operating characteristic curves (AUCs) of 0.976 (95% CI: 0.924–0.995) and 0.827 (95% CI: 0.752–0.887), respectively, were demonstrated between clear cell renal cell carcinoma (ccRCC) and papillary RCC (pRCC)/oncocytoma. The 3D analysis allowed the differentiation of ccRCC from chromophobe RCC (chrRCC) with a AUC of 0.643 (95% CI: 0.555–0.724). Wash-out values proved useful only for discrimination between ccRCC and oncocytoma (43.34 vs 64.10, p < 0.001). However, the relative tumor enhancement ratio (corticomedullary (CM) and nephrographic phases) proved useful for discrimination between ccRCC, pRCC, and chrRCC, with the values from the CM phase having higher AUCs of 0.973 (95% CI: 0.929–0.993) and 0.799 (95% CI: 0.721–0.864), respectively. Conclusions: Our observations point out that imaging features may contribute to providing prognostic information helpful in the management strategy of renal masses.

scholarly journals Characteristics of hepatic solitary necrotic nodules on contrast-enhanced ultrasonography

2020 ◽  
Author(s):  
Chunyu Lu ◽  
Shaoshan Tang ◽  
Xiaoyue Zhang ◽  
Yang Wang ◽  
Kaiming Wang ◽  
...  
Keyword(s):  
Differential Diagnoses ◽  
Arterial Phase ◽  
Focal Lesions ◽  
Portal Phase ◽  
Contrast Enhanced ◽  
The Us ◽  
Contrast Enhanced Ultrasonography ◽  
Dynamic Enhancement ◽  
Delayed Phase ◽  
Single Lesion

Abstract Background:To summarize the characteristics of solitary necrotic nodules (SNN) in the liver observed under contrast-enhanced ultrasonography (CEUS), and to improve the differential diagnoses value of CEUS on liver focal lesions.Methods:Conventional ultrasonography (US) and CEUS were performed in 24 patients who were confirmed to have SNN by pathological assessment. The US data and dynamic enhancement patterns of CEUS were recorded and retrospectively analyzed.Results:All patients underwent CEUS, and of these, 10 patients underwent surgical resection, while 14 patients underwent a puncture biopsy to confirm SNN. Among the 24 patients, 13 patients had a single lesion and 11 patients had multiple lesions. Eleven patients presented no enhancement in all three phases, while the other 13 patients presented with a peripheral thin rim-like enhancement in the arterial phase, an iso-enhancement in the portal phase and delayed phase, and no enhancement in the interior of the lesions. Conclusions:SNN has characteristic findings on the CEUS, which play an important role in the differential diagnoses of liver focal lesions.

scholarly journals Characteristics of hepatic solitary necrotic nodules on contrast-enhanced ultrasonography

2020 ◽  
Author(s):  
Chunyu Lu ◽  
Shaoshan Tang ◽  
Xiaoyue Zhang ◽  
Yang Wang ◽  
Kaiming Wang ◽  
...  
Keyword(s):  
Arterial Phase ◽  
Focal Lesions ◽  
Portal Phase ◽  
Contrast Enhanced ◽  
The Us ◽  
Puncture Biopsy ◽  
Contrast Enhanced Ultrasonography ◽  
Dynamic Enhancement ◽  
Delayed Phase ◽  
Single Lesion

Abstract Background:To summarize the characteristics of solitary necrotic nodules (SNN) in the liver observed under contrast-enhanced ultrasonography (CEUS).Methods:Conventional ultrasonography (US) and CEUS were performed in 24 patients who were confirmed to have SNN by pathological assessment. The US data and dynamic enhancement patterns of CEUS were recorded and retrospectively analyzed.Results:All patients underwent CEUS, and of these, 10 patients underwent surgical resection, while 14 patients underwent a puncture biopsy to confirm SNN. Among the 24 patients, 13 patients had a single lesion and 11 patients had multiple lesions，the largest lesion was selected for CEUS examination. Eleven patients presented no enhancement in all three phases, while the other 13 patients presented with a peripheral thin rim-like enhancement in the arterial phase, an iso-enhancement in the portal phase and delayed phase, and no enhancement in the interior of the lesions. Conclusions:SNN has characteristic findings on the CEUS, which play an important role in the differential diagnoses of liver focal lesions.

scholarly journals Malignant renal tumors in children

2015 ◽  
Vol 2 (3) ◽  
pp. 84-89 ◽  
Author(s):  
Justin Scott Lee ◽  
Thomas Ray Sanchez ◽  
Sandra Wootton-Gorges
Keyword(s):  
Clear Cell ◽  
Wilms Tumor ◽  
Pediatric Population ◽  
Medullary Carcinoma ◽  
Clear Cell Sarcoma ◽  
Renal Tumors ◽  
Malignant Rhabdoid Tumor ◽  
Renal Masses ◽  
The Common ◽  
Prompt Diagnosis

Renal malignancies are common in children. While the majority of malignant renal masses are secondary to Wilms tumor, it can be challenging to distinguish from more aggressive renal masses. For suspicious renal lesions, it is crucial to ensure prompt diagnosis in order to select the appropriate surgical procedure and treatment. This review article will discuss the common differential diagnosis that can be encountered when evaluating a suspicious renal mass in the pediatric population. This includes clear cell sarcoma of the kidney, malignant rhabdoid tumor, renal medullary carcinoma and lymphoma. 

scholarly journals The role of ct-perfusion for diagnostic of solid renal tumors

2021 ◽  
Vol 12 (2) ◽  
pp. 70-78
Author(s):  
N. A. Rubtsova ◽  
A. B. Golbitc ◽  
E. V. Kryaneva ◽  
D. O. Kabanov ◽  
B. Yа. Alekseev ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clear Cell ◽  
Malignant Tumors ◽  
Ct Perfusion ◽  
Renal Tumors ◽  
Renal Masses ◽  
Perfusion Computed Tomography ◽  
Preoperative Stage ◽  
Significant Difference

Introduction. Nowdays, CT and/or MRI do not have sufficient specificity for the differential diagnosis of benign renal masses (oncocytoma and angiomyolipoma with minimal fat) from malignant tumors, and therefore all patients undergo surgical treatment.Purpose and objectives. The aim of the study was to evaluate the diagnostic effectiveness of perfusion computed tomography (PCT) for the differential diagnosis of solid renal masses.Materials and methods. The data of 60 patients (61,28±8,46 years) with primary founded solid renal tumors, who underwent PCT at the preoperative stage, were analyzed. Four perfusion indicators, such as BV, BF, PS and MTT, for the renal masses and normal cortex were evaluated.Results. According to the results of the statistical analysis, the perfusion parameters BV, BF, PS of the renal cortex were significantly higher than in tumors of any histological type (p<0,05). A statistically significant difference was found between clear cell, chromophobe and papillary types of renal cell carcinoma in terms of BV and BF (p<0,05), between benign and malignant tumors — in MTT.Conclusions. PCT has great potential in the assessment of neoangiogenesis and differential diagnosis of solid renal masses.

scholarly journals MDCT angiography in evaluation of pediatric hemangiomas and peripheral vascular malformations

2018 ◽  
Vol 6 (12) ◽  
pp. 4087
Author(s):  
Rohini Gupta Ghasi ◽  
Varun Narayan ◽  
Brij Bhushan Thukral
Keyword(s):  
Soft Tissue Mass ◽  
Vascular Malformations ◽  
Maximum Intensity Projection ◽  
Arterial Phase ◽  
Venous Malformations ◽  
Mdct Angiography ◽  
Tissue Mass ◽  
Peak Enhancement ◽  
Venous Phase ◽  
Delayed Phase

Background: To evaluate the role of MDCT angiography in peripheral hemangiomas and vascular malformations in pediatric patients.Methods: Total of 36 consecutive pediatric patients with clinically suspected peripheral hemangiomas and peripheral malformations were included in the study. MDCT angiography and doppler sonography was done for all patients. Final diagnosis was made by response to treatment and follow up. The statistical significance of various MDCT findings and post processing techniques was calculated. p value of <0.05 was considered significant.Results: Venous malformations were the most common. The MDCTA features which were significant in diagnosing venous malformations were phleboliths (p=0.039), peak enhancement in venous or delayed phase, absence of soft tissue mass, lacy tangle of vessels on maximum intensity projection and volume rendered images. Features significant in diagnosing arteriovenous malformations were tortuous arterial feeders, peak enhancement in arterial phase (0.0001), early draining vein (p=0.0001), venous phase wash out (p=0.0001), tense tangle of vessels on maximum intensity projection and volume rendered images (p=0.0003). Phleboliths (p=0.43) and venous or delayed phase peak enhancement (p=0.69) were overlapping features in congenital hemangiomas and venous malformations. Arterial phase enhancement (p=0.10) and early draining veins (p=0.39) were overlapping features in infantile proliferating hemangiomas and arteriovenous malformations. However, presence of soft tissue mass (p=0.0001) and lack of venous phase wash out (p=0.0003) were differentiating features for hemangiomas.Conclusions: MDCT angiography can be used as a highly accurate modality to diagnose hemangiomas and vascular malformations. It has an advantage over color Doppler in depicting entire extent of deep lesions.

scholarly journals Two Cases of Sporadic Eosinophilic Solid and Cystic Renal Cell Carcinoma in Manitoba Population

2021 ◽  
pp. 106689692199322
Author(s):  
Seyed Mohammad Mohaghegh Poor ◽  
Shivani Mathur ◽  
Karl Kassier ◽  
Janetta Rossouw ◽  
Robert Wightman ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Preoperative Imaging ◽  
Renal Neoplasm ◽  
Renal Masses ◽  
Cystic Renal Cell Carcinoma ◽  
Eosinophilic Cytoplasm ◽  
Clear Cell Rcc

Two sporadic cases of eosinophilic solid and cystic renal cell carcinoma (ESC RCC), at our institution, are presented in this study to contribute to the growing literature on this novel renal neoplasm. The first patient was a 38-year-old female with two synchronous renal masses measuring 3.5 and 1.9 cm on preoperative imaging. The second patient was a 44-year-old female with an incidental renal mass measuring 4 cm. Both patients underwent uncomplicated radical nephrectomies. The 1.9 cm mass in the first patient was consistent with clear cell RCC. The dominant mass in the first patient and the tumor in the second patient had microscopic and macroscopic findings in keeping with ESC RCC including a tan appearance, abundant eosinophilic cytoplasm, and CK20+ and CK7− staining. Both patients had an uncomplicated course following surgery with no evidence of local recurrence or distant metastatic disease for 1 and 2 years for the first and second patient accordingly. These cases contribute to a growing body of literature regarding ESC RCC including, to our knowledge, the first reported case of synchronous ESC RCC and clear cell RCC. Further research about this novel renal neoplasm is needed.

scholarly journals Renal angiomyoadenomatous tumor (RAT): a rare distinct entity with diagnostic challenges—a case report

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Ankur Majumder ◽  
Ravi Hari Phulware ◽  
Arvind Ahuja ◽  
Anurag Singla ◽  
Pawan Kumar
Keyword(s):  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Close Association ◽  
Good Prognosis ◽  
Renal Tumors ◽  
Team Approach ◽  
Renal Neoplasm ◽  
Presenting Symptoms ◽  
Long Term Follow Up

Abstract Background Renal angiomyoadenomatous tumor (RAT) is a recently described rare renal neoplasm with variations in the presentation, gross, and microscopic findings, and having a benign course and good prognosis. It is characterized microscopically by the admixture of three components—epithelial cells arranged in tubules and nests, angiomyomatous stroma, and capillary-sized interconnecting vascular channels in close association with the epithelial cell clusters. Microscopically, these tumors can be confused with clear cell carcinoma, papillary carcinoma, mixed epithelial and stromal tumors, and angiomyolipoma. RAT differs from conventional clear cell carcinomas, which can rarely be associated with an identical leiomyomatosis stroma occasionally forming abortive vascular structures. RAT is a distinct morphologic entity, being different morphologically, immunohistochemically, and genetically from all renal tumors including conventional clear cell carcinoma and mixed epithelial and stromal tumor of the kidney. Case presentation Here, we report a case of a 21-year-old man with renal angiomyoadenomatous tumor, a rare neoplasm with only a few previous cases reported in the literature. Unlike our case, most tumors have been identified in middle-aged males; they present as well-circumscribed, encapsulated tan-brown masses with variably prominent cystic areas. Conclusion Diagnosis of RAT is challenging because of the rarity of the disease and common presenting symptoms to other renal pathology and is supplemented with histopathology and immunohistochemistry. A multidisciplinary team approach for diagnosis and management along with long-term follow-up are warranted.

Mutations in the VHL gene from potassium bromate-induced rat clear cell renal tumors

2002 ◽  
Vol 187 (1-2) ◽  
pp. 207-214 ◽  
Author(s):  
Yih-Horng Shiao ◽  
Sonie I Kamata ◽  
Leeanne M Li ◽  
Michelle J Hooth ◽  
Anthony B DeAngelo ◽  
...  
Keyword(s):  
Clear Cell ◽  
Potassium Bromate ◽  
Renal Tumors ◽  
Vhl Gene
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