title: Clear cell renal cell carcinoma and papillary renal cell carcinoma: differentiation of distinct histological types with multiphase CT.
abstract: OBJECTIVE
  Conventional clear cell renal cell carcinoma (ccRCC) and papillary renal cell carcinoma (pRCC) have different behavioral characteristics and clinical management strategies (nephrectomy vs. nephron-sparing surgery). Our aim was to retrospectively evaluate the contrast enhancement pattern of ccRCC and pRCC and evaluate its possible diagnostic role for preoperative differentiation using a standardized protocol.
  
  
  METHODS
  Quadriphasic multidetector computed tomography (CT) images (unenhanced, corticomedullary, nephrographic, and excretory phases) of 19 patients with 20 ccRCC and 14 patients with 15 pRCC lesions (mean ages, 62.3±14.1 and 61.4±13.7 years, respectively) were reviewed retrospectively. The attenuation characteristics were compared with the attenuation of the normal renal cortex using either multiple 10 mm2 regions of interest or whole tumor attenuation measurements. The degree of contrast enhancement was also compared.
  
  
  RESULTS
  Univariate analysis revealed that ccRCC lesions showed higher mean attenuation values on the corticomedullary and nephrographic phases compared with pRCC masses (P < 0.05) using both measurement techniques.
  
  
  CONCLUSIONS
  The findings underscore the importance of multiphase CT in the differentiation of these two subtypes of RCC using standard assessment techniques. The measurement of the degree of enhancement on contrast-enhanced multidetector CT may be a simple and useful method to radiologically differentiate between the two histological types of RCC.
authors.affiliation: Department of Radiology, Semmelweis University School of Medicine, Budapest, Hungary.
authors.forename: Pal
authors.initials: P
authors.lastname: Bata
authors.forename: Janos
authors.initials: J
authors.lastname: Gyebnar
authors.forename: David Laszlo
authors.initials: DL
authors.lastname: Tarnoki
authors.forename: Adam Domonkos
authors.initials: AD
authors.lastname: Tarnoki
authors.forename: Dora
authors.initials: D
authors.lastname: Kekesi
authors.forename: Attila
authors.initials: A
authors.lastname: Szendroi
authors.forename: Bence
authors.initials: B
authors.lastname: Fejer
authors.forename: A Marcell
authors.initials: AM
authors.lastname: Szasz
authors.forename: Peter
authors.initials: P
authors.lastname: Nyirady
authors.forename: Kinga
authors.initials: K
authors.lastname: Karlinger
authors.forename: Viktor
authors.initials: V
authors.lastname: Berczi
mesh_terms: D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide