Abstract
To determine whether multiphasic MDCT enhancement can help identify the gain of chromosome 12 in clear cell renal cell carcinomas (RCCs). With IRB approval for this HIPAA-compliant case control study, we derived a cohort of 65 clear cell RCCs with preoperative four-phase renal mass MDCT from October 2000 to August 2013. Each lesion was segmented in its entirety on axial images in all phases. A computer-assisted detection (CAD) algorithm selected a 0.5-cm-diameter region of maximal attenuation within each lesion in each phase. Attenuation in each phase between clear cell RCCs with and without the gain of 12 was compared using t-tests. While the entire cohort of clear cell RCCs exhibited peak enhancement in the corticomedullary phase, the subcohort of lesions with the gain of 12 exhibited significantly greater enhancement in the nephrographic (179 vs. 145HU, p=0.004) and excretory phases (147 vs. 118HU, p=0.004) than the subcohort of lesions without the gain of 12. A nephrographic threshold of 186HU identified the gain of 12 with an accuracy of 86% (56/65), specificity of 93% (51/55), and negative predictive value of 91% (51/56). Multiphasic MDCT enhancement, specifically enhancement in the nephrographic and excretory phases, may potentially assist in identifying the gain of 12 in clear cell RCCs.
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