title: Dynamic computed tomography and Doppler findings in different subtypes of renal cell carcinoma with their histopathological correlation.
abstract: BACKGROUND
  Renal cell carcinoma (RCC) is by far the most common soft-tissue mass and accounts for 85% of all malignant masses of the kidney. Histopathological subtype has clinical implications in the form of prognosis and response to various newer and adjuvant treatment strategies.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the morphology and enhancement patterns of different subtypes of RCC and correlate them with their histopathological subtypes.
  
  
  METHODS
  The study group comprised of 20 consecutive patients of RCC. The patients were evaluated with multi-detector-row computed tomography (MDCT) and Doppler ultrasound prior to surgery and findings compared with histopathological subtypes of tumor.
  
  
  RESULTS
  RCC was confirmed on histopathology. Out of 20 patients with RCC, 14 were finally diagnosed as clear cell, 4 chromophobe and 2 as papillary subtypes of RCC. None of clear-cell type showed homogenous enhancement. The mean attenuation in corticomedullary phase (CMP) and nephrographic phase (NP) for clear cell and chromophobe subtype was higher than papillary subtype, i.e. 116.1 ± 27 HU and 91.9 ± 21 HU for clear cell, 103 ± 22.4 HU and 96.2 ± 9.2 HU for chromophobe subtype and 78.5 ± 12.4 HU and 73.3 ± 12.2 HU for papillary subtype respectively. On Doppler US evaluation, non-clear-cell subtypes, which showed heterogenous enhancement on MDCT showed less color flow and peak systolic velocity (PSV). The difference in PSV and Doppler shift frequency values between clear-cell carcinoma and chromophobe subtypes were statistically significant (P = 0.003).
authors.affiliation: Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India.
authors.forename: Binit
authors.initials: B
authors.lastname: Sureka
authors.forename: Anupam
authors.initials: A
authors.lastname: Lal
authors.forename: N
authors.initials: N
authors.lastname: Khandelwal
authors.forename: Kusum
authors.initials: K
authors.lastname: Joshi
authors.forename: S K
authors.initials: SK
authors.lastname: Singh
authors.forename: Mayank M
authors.initials: MM
authors.lastname: Agarwal
authors.forename: Aliza
authors.initials: A
authors.lastname: Mittal
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden; D018608:Ultrasonography, Doppler