MP61-02 DIFFERENTIATION OF RENAL MASS HISTOLOGY AND GRADE UTILIZING DUAL-ENERGY COMPUTED TOMOGRAPHY

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance III (MP61)1 Sep 2021MP61-02 DIFFERENTIATION OF RENAL MASS HISTOLOGY AND GRADE UTILIZING DUAL-ENERGY COMPUTED TOMOGRAPHY Rishi Sekar, Giuseppe Toia, Achille Mileto, and George Schade Rishi SekarRishi Sekar More articles by this author , Giuseppe ToiaGiuseppe Toia More articles by this author , Achille MiletoAchille Mileto More articles by this author , and George SchadeGeorge Schade More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002101.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Dual-Energy Computed Tomography (DECT) has been shown to more accurately characterize renal mass vascularity, however its ability to differentiate tumor subtypes remains unclear. Herein, we investigate the role of DECT and iodine concentration as a derived imaging biomarker in predicting tumor histology and Fuhrman Nuclear Grade (FNG). METHODS: Our institutional database was queried for patients who underwent contrast enhanced DECT to characterize renal masses with subsequent pathologic diagnosis within our institution from 2018 to present. Tumor histology and FNG were obtained from internal pathologic evaluation. Tumor enhancement was measured in Hounsfield Units (HU) using standard techniques. Tumor iodine concentration (mg/mL) was calculated from the maximally enhancing region within each tumor in the nephrogenic phase. Mean enhancement (ME) and mean iodine concentration (MIC) were stratified by histology, and across FNG for clear cell renal cell carcinoma (ccRCC) and compared between groups using Student’s t-test. RESULTS: Our study cohort consisted of 39 separate renal solid enhancing masses. Diagnosis was ccRCC in 22 (56.4%), non-ccRCC in 12 (30.8%), and oncocytoma in 5 (12.8%). Among RCCs, both ME and MIC were statistically significantly higher for ccRCCs versus non-ccRCCs (ME: 116.0 vs. 65.9 HU, p=0.02; MIC: 5.5 vs 3.8 mg/mL, p=0.02).Among ccRCCs, ME was lower for high grade (FNG 3 and 4) versus low grade (FNG 1 and 2) tumors (86.2 vs. 145.9 HU, p=0.1), while MIC was higher (5.7 vs 5.4 mg/mL, p=0.7), however these relationships did not reach statistical significance. Further, ME was higher for chromophobe RCC versus oncocytoma (115 vs. 104.4 HU), while MIC was lower (5.3 vs 6.7 mg/mL, no statistical analysis performed due to small sample size). CONCLUSIONS: DECT imaging with tumor MIC may improve the diagnostic ability to differentiate between renal mass histologies compared to standard contrast enhanced CT imaging. Our preliminary data shows a trend towards higher iodine concentration in high grade ccRCCs compared to low grade tumors and benign histologies. Further investigation with larger cohorts is needed to delineate diagnostic thresholds and allow correlation with oncologic outcomes that could lead to improved prognostic tools. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1083-e1083 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rishi Sekar More articles by this author Giuseppe Toia More articles by this author Achille Mileto More articles by this author George Schade More articles by this author Expand All Advertisement Loading ...