Caecilia S. Reiner MD, Presenter: Nothing to Disclose

Thore Thiesler, Abstract Co-Author: Nothing to Disclose

Daniel Eberli, Abstract Co-Author: Nothing to Disclose

Ernst Klotz PhD, Abstract Co-Author: Employee, Siemens AG

Thomas Frauenfelder MD, Abstract Co-Author: Nothing to Disclose

Hatem Alkadhi MD, Abstract Co-Author: Nothing to Disclose

Tullio Sulser MD, Abstract Co-Author: Nothing to Disclose

Holger Moch, Abstract Co-Author: Nothing to Disclose

To systematically analyze the correlation between computed tomographiy (CT) perfusion and histopathological angiogenic and prognostic markers in patients with renal cell carcinoma (RCC).

Fifteen patients (12 male; mean age 64.5±9.4years) with RCC underwent contrast-enhanced CT perfusion imaging (scan-range 10cm, scan-time 40sec, 128-section CT) one day prior to surgery. The procedure for surgical specimen processing was modified to obtain an exact match with CT images. Microvessel density (MVD) was quantified by CD34 staining. The CT perfusion values blood flow (BF), blood volume (BV), and flow extraction-product (KTrans) were calculated using the maximum-slope and a delay-corrected modified Patlak approach and were correlated to the MVD. Additionally, relationship between the prognostic markers pT stage, Fuhrman grade, microscopic vascular invasion, sarcomatoid features, and tumor necrosis and CT perfusion were evaluated.

BF and BV of RCC both including and excluding necrotic regions showed high significant correlations with MVD (r=0.600-r=0.829, P<.05 each). Significant correlations between MVD and KTrans were only found in small tumor areas exhibiting no necrosis (r=0.550, P<.05). With higher pT stage and Fuhrman grade, and in the presence of microscopic vascular invasion and sarcomatoid features, BF, BV and KTrans were lower, similar to the MVD, but without reaching statistical significance. BF, BV, and KTrans were significantly higher in RCCs with <50% necrosis than in those with ≥50% necrosis (P<.05 each).

Our study indicates that BF and BV from CT perfusion reflects angiogenesis of RCC. CT perfusion parameters differ significantly depending on the degree of tumor necrosis.

CT perfusion imaging reflects tumor angiogenesis of renal cell cancer non-invasively and thus could be used in selecting eligible patients and to monitor treatment response to targeted antiangiogenic

Reiner, C, Thiesler, T, Eberli, D, Klotz, E, Frauenfelder, T, Alkadhi, H, Sulser, T, Moch, H, Computed Tomography Perfusion Imaging of Renal Cell Carcinoma: Systematic Comparison with Histopathological Angiogenic and Prognostic Markers.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12034934.html