Qualitative and quantitative assessment of non-clear cell renal cell carcinoma using contrast-enhanced ultrasound.

BMC Urol

Department of Ultrasound, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.

Published: June 2024

AI Article Synopsis

  • Non-clear cell renal cell carcinoma (nccRCC) is a rare form of kidney cancer that can be misdiagnosed, making it crucial to identify its unique characteristics through contrast-enhanced ultrasound (CEUS).
  • This study analyzed imaging features from 21 patients with confirmed nccRCC to evaluate the effectiveness of both qualitative and quantitative CEUS in diagnosis.
  • The results revealed that nccRCC commonly shows specific traits in ultrasound imaging, like hypoechoic appearance and clear boundaries, and CEUS analysis indicated significant differences in blood flow parameters between nccRCC lesions and normal renal tissue.

Article Abstract

Background: Non-clear cell renal cell carcinoma (nccRCC) represents a rare form of renal cell carcinoma (RCC) in the clinic. It is now understood that contrast-enhanced ultrasound (CEUS) exhibits diverse manifestations and can be prone to misdiagnosis. Therefore, summarizing the distinctive features of contrast-enhanced ultrasonography is essential for differentiation from ccRCC.

Objective: This study aims to evaluate the diagnostic efficacy of qualitative and quantitative CEUS in diagnosing nccRCC to enhance our understanding of this condition.

Methods: We conducted a retrospective analysis of 21 patients with confirmed nccRCC following surgery and assessed the characteristic conventional ultrasound and CEUS imaging features. The paired Wilcoxon signed-rank sum test was employed to compare differences in CEUS time-intensity curve (TIC) parameters between the lesions and the normal renal cortex.

Results: Routine ultrasound revealed the following primary characteristics in the 21 nccRCC cases: hypoechoic appearance (10/21, 47.6%), absence of liquefaction (18/21, 66.7%), regular shape (19/21, 90.5%), clear boundaries (21/21, 100%), and absence of calcification (17/21, 81%). Color Doppler flow imaging (CDFI) indicated a low blood flow signal (only 1 case of grade III). Qualitative CEUS analysis demonstrated that nccRCC predominantly exhibited slow progression (76.1%), fast washout (57%), uniformity (61.9%), low enhancement (71.5%), and ring enhancement (61.9%). Quantitative CEUS analysis revealed that parameters such as PE, WiAUC, mTTI, WiR, WiPI, WoAUC, WiWoAUC, and WOR in the lesions were significantly lower than those in the normal renal cortex (Z=-3.980, -3.563, -2.427, -3.389, -3.980, -3.493, -3.528, -2.763, P < 0.001, < 0.001, = 0.015, = 0.001, < 0.001, < 0.001, < 0.001, = 0.006). However, there were no significant differences in RT, TTP, FT, or QOF (all P > 0.05).

Conclusion: nccRCC exhibits distinctive CEUS characteristics, including slow progression, fast washout, low homogeneity enhancement, and ring enhancement, which can aid in distinguishing nccRCC from ccRCC.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181612PMC
http://dx.doi.org/10.1186/s12894-024-01514-8DOI Listing

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