NDLI: Is a single portal venous phase in contrast-enhanced CT sufficient to detect metastases or recurrence in clear cell renal cell carcinoma?

Content Provider	Springer Nature : BioMed Central
Author	Hagen, Florian Peisen, Felix Spogis, Jakob Mair, Antonia Nikolaou, Konstantin Stenzl, Arnulf Kruck, Stephan Bedke, Jens Kaufmann, Sascha Thaiss, Wolfgang M.
Abstract	Background This study aims at describing the imaging features of the metastatic presentation of clear cell renal cell carcinoma (ccRCC) in arterial (AP) and portal venous phase (PVP) of contrast-enhanced-computed-tomography (CECT) during clinical follow-up (FU) and to evaluate the necessity of a dual phase approach for metastasis detection. Methods We identified a total of 584 patients that were diagnosed with ccRCC between January 2016 and April 2020. Inclusion criteria were histologically proven ccRCC with metastatic spread, proven by histology or interim follow-up of at least 2 years and follow-up CT examination with AP and PVP CECT including thorax/abdomen and pelvis. Exclusion criteria were defined by missing or incomplete CT-scans or lack of sufficient follow-up. CT studies of 43 patients with histologically proven ccRCCs were analyzed in retrospect. AP and PVP images were analyzed by two radiologists for metastases, two additional independent radiologists analyzed PVP images only. A 5-point Likert scale was used to evaluate the likelihood off the presence of metastasis. Imaging patterns of the metastases were analyzed visually. Results 43 patients (16 female; mean age: 67±10 years) with recurrent ccRCC and metastatic disease were included. Three imaging patterns were observed (solid, heterogeneous or cystic metastases), which rarely exhibited calcifications (2%). All metastases showed hyperenhancement in AP and PVP. Inter-reader agreement was substantial (Fleiss’ κ 0.6–0.8, p<0.001). No significant differences in sensitivity or specificity between readers (AP and PVP images vs. PVP images only) were present (79.4-85.2%, 97.1-99.6%, p ≥ 0.05). The area under the receiver-operating-characteristic (ROC) curve was between 0.901and 0.922 for all four radiologists. Conclusions Similar rates for detection, sensitivity and specificity of metastasis and local recurrence in ccRCC were observed irrespective of using a dual-phase protocol with AP and PVP or a single PVP protocol only. Thus, a single-phase examination of PVP can be sufficient for experienced radiologists to detect metastatic disease in the follow-up of ccRCC patients.
Related Links	https://cancerimagingjournal.biomedcentral.com/counter/pdf/10.1186/s40644-022-00444-8.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14707330
DOI	10.1186/s40644-022-00444-8
Journal	Cancer Imaging
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2022-01-21
Access Restriction	Open
Subject Keyword	Oncology Cancer Research Imaging Radiology Nuclear Medicine Arterial contrast phase Image quality Interreader-agreement Portal venous contrast phase Renal cell carcinoma
Content Type	Text
Resource Type	Article
Subject	Radiological and Ultrasound Technology Radiology, Nuclear Medicine and Imaging Oncology
Journal Impact Factor	3.5/2023
5-Year Journal Impact Factor	4.3/2023

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