title: Percutaneous Needle Based Optical Coherence Tomography for the Differentiation of Renal Masses: a Pilot Cohort.
abstract: We determine the ability of percutaneous needle based optical coherence tomography to differentiate renal masses by using the attenuation coefficient (μOCT, mm(-1)) as a quantitative measure.
  
  
  
  Percutaneous needle based optical coherence tomography of the kidney was performed in patients presenting with a solid renal mass. A pathology specimen was acquired in the form of biopsies and/or a resection specimen. Optical coherence tomography results of 40 patients were correlated to pathology results of the resected specimens in order to derive μOCT values corresponding with oncocytoma and renal cell carcinoma, and with the 3 main subgroups of renal cell carcinoma. The sensitivity and specificity of optical coherence tomography in differentiating between oncocytoma and renal cell carcinoma were assessed through ROC analysis.
  
  
  
  The median μOCT of oncocytoma (3.38 mm(-1)) was significantly lower (p=0.043) than the median μOCT of renal cell carcinoma (4.37 mm(-1)). ROC analysis showed a μOCT cutoff value of greater than 3.8 mm(-1) to yield a sensitivity, specificity, positive predictive value and negative predictive value of 86%, 75%, 97% and 37%, respectively, to differentiate between oncocytoma and renal cell carcinoma. The area under the ROC curve was 0.81. Median μOCT was significantly lower for oncocytoma vs clear cell renal cell carcinoma (3.38 vs 4.36 mm(-1), p=0.049) and for oncocytoma vs papillary renal cell carcinoma (3.38 vs 4.79 mm(-1), p=0.027).
  
  
  
  We demonstrated that the μOCT is significantly higher in renal cell carcinoma vs oncocytoma, with ROC analysis showing promising results for their differentiation. This demonstrates the potential of percutaneous needle based optical coherence tomography to help in the differentiation of renal masses, thus warranting ongoing research.
authors.affiliation: Department of Urology, AMC University Hospital, Amsterdam, The Netherlands. Electronic address: p.g.wagstaff@amc.nl.
authors.forename: Peter G K
authors.initials: PGK
authors.lastname: Wagstaff
authors.affiliation: Department of Urology, AMC University Hospital, Amsterdam, The Netherlands; Department of Urology, IR4M Institut de Cancerologie Gustave Roussy, Paris, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Ingels
authors.affiliation: Department of Urology, AMC University Hospital, Amsterdam, The Netherlands; Department of Biomedical Engineering & Physics, AMC University Hospital, Amsterdam, The Netherlands.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: de Bruin
authors.affiliation: Department of Urology, AMC University Hospital, Amsterdam, The Netherlands.
authors.forename: Mara
authors.initials: M
authors.lastname: Buijs
authors.affiliation: Department of Urology, AMC University Hospital, Amsterdam, The Netherlands.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Zondervan
authors.affiliation: Department of Pathology, AMC University Hospital, Amsterdam, The Netherlands.
authors.forename: C Dilara
authors.initials: CD
authors.lastname: Savci Heijink
authors.affiliation: Department of Radiology, AMC University Hospital, Amsterdam, The Netherlands.
authors.forename: Otto M
authors.initials: OM
authors.lastname: van Delden
authors.affiliation: Department of Biomedical Engineering & Physics, AMC University Hospital, Amsterdam, The Netherlands.
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Faber
authors.affiliation: Department of Biomedical Engineering & Physics, AMC University Hospital, Amsterdam, The Netherlands.
authors.forename: Ton G
authors.initials: TG
authors.lastname: van Leeuwen
authors.affiliation: Department of Urology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: R Jeroen A
authors.initials: RJA
authors.lastname: van Moorselaar
authors.affiliation: Department of Urology, AMC University Hospital, Amsterdam, The Netherlands.
authors.forename: Jean J M C H
authors.initials: JJMCH
authors.lastname: de la Rosette
authors.affiliation: Department of Urology, AMC University Hospital, Amsterdam, The Netherlands.
authors.forename: M Pilar
authors.initials: MP
authors.lastname: Laguna Pes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007680:Kidney Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009339:Needles; D009367:Neoplasm Staging / Q000379:methods; D010865:Pilot Projects; D012372:ROC Curve; D041623:Tomography, Optical Coherence / Q000295:instrumentation*
keywords: biopsy; carcinoma, renal cell; diagnosis; tomography, optical coherence