Génétique héréditaire : recherche actuelle

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Utility of CT Perfusion Imaging for Grading of Clear Cell Renal Cell Carcinoma

Yue-Lang Zhang, Juan Ren, Bo-Lang Yu, Kai Qu, Ke Wang, Yong-Qian Qiang, Chen-Xia Li, Xing-Wang Sun

Objective: To investigate the correlation between 64-slice spiral CT perfusion imaging of clear cell renal cell carcinoma (CCRCC) and Fuhrman’s nucleus grading.

Methods: A total of 54 cases of pathologically confirmed CCRCC were consecutively included, and underwent 64-slice spiral CT perfusion imaging. The perfusion fraction (PF) of the contralateral and ipsilateral part of kidney and the tumor was measured respectively. The peak enhancement intensity (PEI) and blood volume (BV) were measured as well. T-test was performed in PF, BV and PEI value between contralateral kidney and CCRCC, between low-grade and high-grade CCRCC. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of PF and BV in distinguishing clear cell carcinoma with different grade. The diagnostic accuracy of PF and BV was also tested after conventional CT screening.

Results: There were significant differences in PF, PEI and BV between the contralateral kidney and renal cell carcinoma (p<0.05). There were also significant differences in PF and BV between low-grade and high-grade clear cell carcinoma (p<0.05). No significant difference was found in PEI between low-grade and high-grade renal cell carcinoma (p>0.05). Single or combined use of the PF and BV showed low accuracy in grading of clear cell carcinoma. The diagnostic accuracy of PF and BV in clear cell carcinoma will be improved by the combination of the perfusion CT and routine CT application.

Conclusion: PF and BV values are significantly higher in high-grade CCRCC than in low-grade CCRCC, and their application will increase the accuracy for detecting high-grade CCRCC than conventional CT scan alone.