You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging I1 Apr 2017MP22-07 CORRELATION OF CAD PEAK LESION ENHANCEMENT WITH QUANTITATIVE TUMOR ANGIOGENESIS TO NON-INVASIVELY ASSESS FURHMAN GRADES I-IV IN PATIENTS WITH CLEAR CELL RENAL CELL CARCINOMA Heidi Coy, Jonathan Young, Michael Douek, Matthew Brown, Anthony Sisk, James Sayre, and Steven Raman Heidi CoyHeidi Coy More articles by this author , Jonathan YoungJonathan Young More articles by this author , Michael DouekMichael Douek More articles by this author , Matthew BrownMatthew Brown More articles by this author , Anthony SiskAnthony Sisk More articles by this author , James SayreJames Sayre More articles by this author , and Steven RamanSteven Raman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.661AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To assess if Computer Aided Detection (CAD) of peak lesion attenuation discriminates among Fuhrman Grades I-IV and correlates with an increase in tumor angiogenesis in clear cell RCC (ccRCC) on four-phase MDCT. METHODS We reviewed a cohort of patients with ccRCC and preoperative multiphasic multidetector CT imaged with a 4-phase renal mass protocol (unenhanced, corticomedullary (C), nephrographic (N), and excretory (E)). A whole lesion 3D contour was obtained in all phases with proprietary software. The CAD algorithm determined a 0.5cm diameter region of peak enhancement ≤300HU within the 3D lesion contour. For assessment of quantitative angiogenesis, immunohistochemical staining for CD34 to determine microvessel density (MVD) was performed. T-tests were used to compare peak multiphasic enhancement and microvessel density among Fuhrman grades I-IV. P values less than 0.05 were considered to be significant. RESULTS 107 patients (71(64%) men and 40(35%) women) with 111 unique ccRCC lesions (16 (14%) Fuhrman grade I, 64 (58%) Fuhrman grade II, 23 (21%) Fuhrman Grade III, 8 (7%) Fuhrman grade IV) were analyzed. In the C phase, CAD peak lesion enhancement discriminated grade I from II (150 HU vs. 185 HU, p=0.006), I from III (150 HU vs. 178 HU, p=0.054), I from IV (150 HU vs 229HU, p<0.001). This directly correlated with an increase in quantitative angiogenesis (MVD): I from II (2134 mm2 vs. 4710 mm2, p=0.004), I from III (2134 mm2 vs. 5162 mm, p=0.001), I from IV (2134 mm2 vs 6076 mm2, p=0.057). CONCLUSIONS CAD peak lesion enhancement discriminates Fuhrman grades 1-IV on multiphasic CT and correlates with an increase in tumor angiogenesis. This may be helpful to triage patients to active surveillance, interventional therapy or, if validated, may be useful to monitor results with anti-angiogenic therapy. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e259 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Heidi Coy More articles by this author Jonathan Young More articles by this author Michael Douek More articles by this author Matthew Brown More articles by this author Anthony Sisk More articles by this author James Sayre More articles by this author Steven Raman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...