Yapay Zeka Hızlı Bakış & Çıkarımlar
AI InsightPatientswith suggested pRCC on CT imaging being considered for a non-extirpative strategy should undergoPRMB for risk stratification.
📌 3 Maddede Bu Makale
Özet
Objective: To investigate the utility of multiphase computed tomography (CT) and percutaneous renal massbiopsy (PRMB) in differentiating between papillary renal cell carcinoma (pRCC)–Type 1 and –Type 2, asemerging data have suggested differential enhancement patterns in different renal tumor histologies.Material and methods: Retrospective analysis of 51 patients (23 pRCC-Type 1/28 pRCC-Type 2) whounderwent multiphase CT followed by surgery from July 2011 to April 2016 was performed. Data wereanalyzed between subgroups based on histology. Multiphase CT was analyzed for tumor size, and attenuation[Hounsfield Units (HU)]. Change in HU (ΔHU) was calculated between noncontrast (NC), corticomedullary(CM), nephrographic (N), and delayed (D) phases. Subset analysis was carried out on patients whounderwent PRMB prior to surgery.Results: There was no difference in median tumor size (pRCC-Type 1 2.8 vs. pRCC-Type 2 2.6 cm, p=0.832).In addition to tumor size being similar between groups, distribution of tumor stages between groups wasalso similar (p=0.651). Greater proportion of high-grade tumors (III/IV) was noted in pRCC-Type 2 (42.9%vs. 8.7%) (p=0.011). There was no difference in HU values for NC (p=0.961), CM (p=0.118), N (p=0.277),and D (p=0.256) phases, and in ΔHU between CM-NC (p=0.278), N-NC (p=0.316), and D-NC (p=0.103).Thirteen patients underwent percutaneous biopsy, 11 of whom had diagnostic samples. Examination of10/11 (90.9%) samples accurately predicted correct histology, and of 6/11 (54.5%) samples correctly identifiedhigh-vs. low-grade histology.Conclusion: Our findings suggest substantial overlap of CT findings, despite pRCC-Type 2 having greaterproportion of high-grade tumors. Utility of CT is limited in the differentiation between pRCC subtypes. Patientswith suggested pRCC on CT imaging being considered for a non-extirpative strategy should undergoPRMB for risk stratification.