Transitional cell and clear cell renal carcinoma: Differentiation of distinct histological types with multiphase CT

Pal Bata, David Laszlo Tarnoki, Adam Domonkos Tarnoki, Pal Kaposi Novak, Janos Gyebnar, Dora Kekesi, Attila Szendroi, Bence Fejer, A. Marcell Szasz, Peter Nyirady, Kinga Karlinger, Viktor Berczi

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Transitional cell carcinoma (TCC) may mimic renal cell carcinoma (RCC) when it develops in a similar location, therefore, differentiation with imaging techniques might be challenging. Preoperative differentiation may have a significant role indicating the type of surgical treatment (nephrectomy vs. ureteronephrectomy). Purpose: To retrospectively analyze the differences in the contrast enhancement of TCC and RCC. Material and Methods: Images of 20 RCC and 12 TCC (mean ages, 62.3±14.1 and 67.4±12.0 years, respectively) were analyzed from patients who underwent multiphase computed tomography (CT) examinations following 1.5 mL/kg non-ionic contrast agent administration. Unenhanced corticomedullary (30-45 s), nephrographic (70-90 s), and excretory (300-480 s) phases were imaged. The attenuation characteristics of RCC and TCC were compared to the attenuation of the normal renal cortex. Results: Significant differences were found in the attenuation ratios between RCC or TCC in the corticomedullary (P=0.040) and nephrographic (P=0.004) phases using three regions of interest (ROIs) of 10mm2 size. If measuring ROIs comprising the complete tumor lesion instead of three small ROIs, no significant difference was observed in the attenuation ratios between RCC in TCC in any phases. Conclusion: Our study reports significant attenuation differences between RCC and TCC in the corticomedullary and nephrographic phases by multiphase CT. The findings underscore the importance of multiphase CT in the differentiation of these two different entities. Using multiple small (three)ROIs is more accurate than measuring the whole tumor attenuation.

Original languageEnglish
Pages (from-to)1112-1119
Number of pages8
JournalActa Radiologica
Volume55
Issue number9
DOIs
Publication statusPublished - Jan 1 2014

Keywords

  • CT
  • Central renal tumor
  • renal cell carcinoma
  • renal neoplasms
  • renal pelvis
  • transitional cell carcinoma

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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