Abstract
BackgroundTo examine the value of energetic-spectrum computed tomography (spectral CT) quantitative parameters in renal cell carcinoma (RCC) microvascular angiogenesis.MethodsThe authors evaluated 32 patients with pathologically confirmed RCC who underwent triple-phase contrast-enhanced CT with spectral CT imaging mode from January 2017 to December 2019. Quantitative parameters include parameters derived from iodine concentration (IC) and water concentration (WC) of 120 keV monochromatic images. All specimens were evaluated including the microvascular density (MVD), microvascular area (MVA) and so on. The correlation between IC and WC (including average values and random values) with microvascular parameters were analyzed with Pearson or Spearman rank correlation coefficients.ResultsThe MVD of all tumors was 26.00 (15.00–43.75) vessels per field at × 400 magnification. The MVD of RCC correlated positively with the mean IC, mean WC, mean NWC, mean NIC, random IC, random NIC in renal cortical phase, WCD1, WCD2, NWCD2 and ICD1 (Spearman rank correlation coefficients, r range, 0.362–0.533; all p < 0.05). The MVA of all tumors was (16.16 ± 8.98) % per field at × 400 magnification. The MVA of RCC correlated positively with the mean IC, mean WC, mean NWC, mean NIC, random IC, random NIC in renal cortical, mean WC and mean NWC in renal parenchymal phase, WCD1, WCD2, WCD3, NWCD2, and NWCD3 (Pearson or Spearman rank correlation coefficients, r range, 0.357–0.576; all p < 0.05). Microvascular grading correlated positively with the mean NWC, mean NIC and random NIC in renal cortical phase, mean NWC in renal parenchymal phase, NWCD2, WCD3, NWCD3, NICD2 and NICD3 (Spearman rank correlation coefficients, r range, 0.367–0.520; all p < 0.05). As for tumor diameter (55.19 ± 19.15), μm, only NWCD3 was associated with it (Spearman rank correlation coefficients, r = 0.388; p < 0.05).ConclusionsICD and WCD of spectral CT have a potential for evaluating RCC microvascular angiogenesis. MVD, MVA and microvascular grade showed moderate positive correlation with ICD and WCD. ICD displayed more relevant than that of WCD. The parameters of renal cortical phase were the best in three phases. NICD and NWCD manifested stronger correlation with microvascular parameters than that of ICD and WCD.
Highlights
Renal cell carcinoma (RCC) is a kind of tumor originated from renal epithelial cells, accounting for more than 90% of renal cell carcinoma, consisting of 2% of adult malignancies [1, 2]
Microvessel density (MVD) and microvessel area (MVA) measured by immunohistochemical technique have been considered as the criteria for evaluating tumor angiogenesis, which reflect the intensity of blood vessels, the area of endothelial lumen and the blood volume for tumor perfusion [7, 8]
This study aims to analyze the relationship between iodine concentration (IC) and water concentration (WC) with RCC angiogenesis
Summary
Renal cell carcinoma (RCC) is a kind of tumor originated from renal epithelial cells, accounting for more than 90% of renal cell carcinoma, consisting of 2% of adult malignancies [1, 2]. Microvessels are curved and organized more irregularly Their walls are more fragile due to the weak connection among endothelial cells, other pericyte layers and basement membrane [6]. Studies on different types of RCC, including papillary and clear cell RCC, demonstrate that MVD and MVA are negatively correlated with survival rate, directly correlated or of no significant difference [9]. The reasons for these contradictory findings are not completely explicit. To examine the value of energetic-spectrum computed tomography (spectral CT) quantitative parameters in renal cell carcinoma (RCC) microvascular angiogenesis
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