Study of 320-slice dynamic volume CT perfusion in different pathologic types of kidney tumor: preliminary results.
OBJECTIVE
To investigate microcirculatory differences between pathologic types of kidney tumor using 320-slice dynamic volume CT perfusion.


METHODS
Perfusion imaging with 320-slice dynamic volume CT was prospectively performed in 85 patients with pathologically proven clear cell renal cell carcinoma (RCC) (n = 66), papillary RCC (n = 7), chromophobe RCC (n = 5), angiomyolipoma (AML) with minimal fat (n = 7), or RCC (n = 78). Equivalent blood volume (Equiv BV), permeability surface-area product (PS; clearance/unit volume = permeability), and blood flow (BF) of tumor and normal renal cortex were measured and analyzed. Effective radiation dose was calculated.


RESULTS
There was a significant difference in all three parameters between tumor and normal renal cortex (P<0.001). Equiv BV was significantly different between RCC and AML with minimal fat (P = 0.038) and between clear cell RCC and AML with minimal fat (P<0.001). Mean Equiv BV and BF were significantly higher in clear cell RCC than in papillary RCC (P<0.001 for both) and mean Equiv BV was higher in clear cell RCC than in chromophobe RCC (P<0.001). The effective radiation dose of the CT perfusion protocol was 18.5 mSv.


CONCLUSIONS
Perfusion imaging using 320-slice dynamic volume CT can be used to evaluate hemodynamic features of the whole kidney and kidney tumors, which may be useful in the differential diagnosis of these four pathologic types of kidney tumor.
Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China.
Chao
C
Chen
Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China.
Qi
Q
Liu
Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China.
Qiang
Q
Hao
Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China.
Bing
B
Xu
Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China.
Chao
C
Ma
Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China.
Huojun
H
Zhang
Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China.
Qianjin
Q
Shen
Department of Radiology, Changhai Hospital of Shang hai, The second Military Medical University, Shanghai, China.
Jianping
J
Lu
D000328:Adult; D000368:Aged; D018207:Angiomyolipoma / Q000098:blood supply* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D002291:Carcinoma, Papillary / Q000098:blood supply* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D002292:Carcinoma, Renal Cell / Q000098:blood supply* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D007479:Iopamidol; D007668:Kidney / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D007680:Kidney Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed / Q000379:methods
D003287:Contrast Media; D007479:Iopamidol