title: A Pilot Clinical Study in Characterization of Malignant Renal-cell Carcinoma Subtype with Contrast-enhanced Ultrasound.
abstract: Malignant renal cell carcinoma (RCC) is a diverse set of diseases, which are independently difficult to characterize using conventional MRI and CT protocols due to low temporal resolution to study perfusion characteristics. Because different disease subtypes have different prognoses and involve varying treatment regimens, the ability to determine RCC subtype non-invasively is a clinical need. Contrast-enhanced ultrasound (CEUS) has been assessed as a tool to characterize kidney lesions based on qualitative and quantitative assessment of perfusion patterns, and we hypothesize that this technique might help differentiate disease subtypes. Twelve patients with RCC confirmed pathologically were imaged using contrast-enhanced ultrasound. Time intensity curves were generated and analyzed quantitatively using 10 characteristic metrics. Results showed that peak intensity ( p = 0.001) and time-to-80% on wash-out ( p = 0.004) provided significant differences between clear cell, papillary, and chromophobe RCC subtypes. These results suggest that CEUS may be a feasible test for characterizing RCC subtypes.
authors.affiliation: 1 Joint Department of Biomedical Engineering, North Carolina State University and The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Sandeep K
authors.initials: SK
authors.lastname: Kasoji
authors.affiliation: 2 Kidney Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Emily H
authors.initials: EH
authors.lastname: Chang
authors.affiliation: 1 Joint Department of Biomedical Engineering, North Carolina State University and The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Lee B
authors.initials: LB
authors.lastname: Mullin
authors.affiliation: 3 Department of Radiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Wui K
authors.initials: WK
authors.lastname: Chong
authors.affiliation: 4 Department of Medicine, Vanderbilty University Hospitals, Nashville, TN, USA.
authors.forename: W Kimryn
authors.initials: WK
authors.lastname: Rathmell
authors.affiliation: 1 Joint Department of Biomedical Engineering, North Carolina State University and The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Dayton
mesh_terms: D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005466:Fluorocarbons; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren
keywords: contrast-enhanced ultrasound; microbubbles; renal cell carcinoma; renal perfusion; time intensity curve