Renal oncocytoma: Is URO‐CT useful in histological diagnosis?
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.24915/aup.33.3.35 |
Resumo: | IntroductionOver the past few years, the increasing use of cross‐sectional imaging, including ultrasound and computed tomography imaging, resulted in an increase incidental diagnosis of renal tumors, especially small renal masses (<4cm). The knowledge that 30% of these masses may be benign, including oncocytomas led to the investigation for more effective methods of diagnosis in order to avoid overtreatment situations.ObjectivesThe authors decided to analyse and compare contrast enhancement patterns of oncocytomas and clear‐cell renal cell carcinoma (ccRCC) to predict histology.Material and methodsBetween 2004‐2015 we retrospectively identified 32 patients with either histological confirmation of renal oncocytoma (N=16) or ccRCC (N=16) who underwent percutaneous biopsy, total or partial nephrectomy. The relative attenuation of solid renal lesions and normal renal cortex was determined in the unenhanced and nephrographic phase. Statistical comparison was carried out by Mann‐Withney test.ResultsThe oncocytomas and cc‐RCC average size was 3.7cm [1.8 to 14] and 3.5cm [1.9 to 8.4], respectively. The average attenuation in the unenhanced phase was 33HU and 32HU, respectively. In nephrographic phase, the average contrast enhancement was 47.5 and 47.4H, respectively. In nephrographic phase, the attenuation difference between the oncocytomas and normal renal cortex was 43.5HU and the attenuation difference between the cc‐RCC and normal renal cortex was 59.7HU. These results were statistically significant (p<0.05).ConclusionsIn the nephrographic phase, URO‐CT reveals that oncocytomas have greater isodensity to the normal renal cortex compared to cc‐RCC. This finding can help us to determine which lesions we should biopsy or not. |
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Renal oncocytoma: Is URO‐CT useful in histological diagnosis?Oncocitoma renal: tem a URO‐TC utilidade no diagnóstico histológico?Renal oncocytomaRenal cell carcinomaDiagnosisURO‐CTOncocitoma renalCarcinoma de células renaisDiagnósticoURO‐TCIntroductionOver the past few years, the increasing use of cross‐sectional imaging, including ultrasound and computed tomography imaging, resulted in an increase incidental diagnosis of renal tumors, especially small renal masses (<4cm). The knowledge that 30% of these masses may be benign, including oncocytomas led to the investigation for more effective methods of diagnosis in order to avoid overtreatment situations.ObjectivesThe authors decided to analyse and compare contrast enhancement patterns of oncocytomas and clear‐cell renal cell carcinoma (ccRCC) to predict histology.Material and methodsBetween 2004‐2015 we retrospectively identified 32 patients with either histological confirmation of renal oncocytoma (N=16) or ccRCC (N=16) who underwent percutaneous biopsy, total or partial nephrectomy. The relative attenuation of solid renal lesions and normal renal cortex was determined in the unenhanced and nephrographic phase. Statistical comparison was carried out by Mann‐Withney test.ResultsThe oncocytomas and cc‐RCC average size was 3.7cm [1.8 to 14] and 3.5cm [1.9 to 8.4], respectively. The average attenuation in the unenhanced phase was 33HU and 32HU, respectively. In nephrographic phase, the average contrast enhancement was 47.5 and 47.4H, respectively. In nephrographic phase, the attenuation difference between the oncocytomas and normal renal cortex was 43.5HU and the attenuation difference between the cc‐RCC and normal renal cortex was 59.7HU. These results were statistically significant (p<0.05).ConclusionsIn the nephrographic phase, URO‐CT reveals that oncocytomas have greater isodensity to the normal renal cortex compared to cc‐RCC. This finding can help us to determine which lesions we should biopsy or not.IntroduçãoAo longo dos últimos anos, a crescente utilização de exames imagiológicos, nomeadamente ecografia e tomografia computorizada (TC), traduziu‐se num aumento do diagnóstico incidental de tumores renais, sobretudo pequenas massas renais (<4cm). O conhecimento de que até 30% destas massas podem ser benignas, entre elas os oncocitomas, levou à procura de métodos de diagnóstico mais eficazes, de forma a evitar situações de sobretratamento e de forma a tomaram‐se decisões terapêuticas mais fundamentadas.ObjetivosAnalisar retrospetivamente uma série de tumores renais histologicamente comprovados, nomeadamente oncocitomas e carcinoma de células renais (CCR), e verificar se existem diferenças morfológicas e/ou nos padrões de captação de contraste através da URO‐TC.Material e métodosIdentificámos todos os tumores renais entre 2004‐2015 com o diagnóstico histológico de oncocitoma e de CCR. Estes resultados foram obtidos por biopsia do tumor renal, tumorectomia/nefrectomia parcial ou nefrectomia radical. Registámos e comparámos as características morfológicas e os padrões de captação de contraste na fase nefrográfica com medição de unidades de Hounsfield (HU) dos oncocitomas e dos CCR (células claras), selecionados de acordo com a dimensão (aprox. idêntica à dos oncocitomas) e obtidos na sequência de tumorectomia renal ou nefrectomia radical.ResultadosIdentificaram‐se 16 CCR e 31 oncocitomas, dos quais 15 foram excluídos por não termos acesso às imagens de TC no sistema informático. A dimensão média dos oncocitomas foi 3,7cm (1,8‐14) e a dos CCR 3,5cm (1,9‐8,4). A atenuação de contraste média dos oncocitomas e dos CCR na fase sem contraste foi de 33 HU e 32 HU, respetivamente. Na fase nefrográfica, a captação média de contraste para os oncocitomas foi de 47,5HU e 47,4HU para os CCR. Na fase nefrográfica, a diferença de atenuação entre os oncocitomas e o parênquima renal normal foi 43,5 HU e a diferença de atenuação entre os CCR e o parênquima renal normal foi 59,7 HU. Estes resultados foram estatisticamente significativos (p<0,05). Não se identificaram outras alterações na fase excretora da TC, nem diferenças relevantes de carácter morfológico, nomeadamente nos contornos das lesões, presença de calcificações, ou de cicatriz central.ConclusõesNa avaliação imagiológica por URO‐TC, nomeadamente na fase nefrográfica, parece existir uma tendência para maior isodensidade dos oncocitomas em relação ao parênquima renal normal. Este achado poderá contribuir para uma melhor decisão terapêutica, na medida em que nos pode direcionar para uma biopsia de confirmação em detrimento da excisão cirúrgica.Associação Portuguesa de Urologia2017-04-11T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.24915/aup.33.3.35oai:oai.actaurologicaportuguesa.com:article/35Acta Urológica Portuguesa; Vol. 33 No. 3 (2016): Setembro-Dezembro; 98-103Acta Urológica Portuguesa; v. 33 n. 3 (2016): Setembro-Dezembro; 98-1032387-04192341-4022reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttp://www.actaurologicaportuguesa.com/index.php/aup/article/view/35https://doi.org/10.24915/aup.33.3.35http://www.actaurologicaportuguesa.com/index.php/aup/article/view/35/5Almeida Dores, JoãoKronenberg, PeterBargão Santos, PedroFerreira, SérgioCarrasquinho Gomes, Franciscoinfo:eu-repo/semantics/openAccess2022-09-21T09:04:45Zoai:oai.actaurologicaportuguesa.com:article/35Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:55:52.564469Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Renal oncocytoma: Is URO‐CT useful in histological diagnosis? Oncocitoma renal: tem a URO‐TC utilidade no diagnóstico histológico? |
title |
Renal oncocytoma: Is URO‐CT useful in histological diagnosis? |
spellingShingle |
Renal oncocytoma: Is URO‐CT useful in histological diagnosis? Almeida Dores, João Renal oncocytoma Renal cell carcinoma Diagnosis URO‐CT Oncocitoma renal Carcinoma de células renais Diagnóstico URO‐TC |
title_short |
Renal oncocytoma: Is URO‐CT useful in histological diagnosis? |
title_full |
Renal oncocytoma: Is URO‐CT useful in histological diagnosis? |
title_fullStr |
Renal oncocytoma: Is URO‐CT useful in histological diagnosis? |
title_full_unstemmed |
Renal oncocytoma: Is URO‐CT useful in histological diagnosis? |
title_sort |
Renal oncocytoma: Is URO‐CT useful in histological diagnosis? |
author |
Almeida Dores, João |
author_facet |
Almeida Dores, João Kronenberg, Peter Bargão Santos, Pedro Ferreira, Sérgio Carrasquinho Gomes, Francisco |
author_role |
author |
author2 |
Kronenberg, Peter Bargão Santos, Pedro Ferreira, Sérgio Carrasquinho Gomes, Francisco |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Almeida Dores, João Kronenberg, Peter Bargão Santos, Pedro Ferreira, Sérgio Carrasquinho Gomes, Francisco |
dc.subject.por.fl_str_mv |
Renal oncocytoma Renal cell carcinoma Diagnosis URO‐CT Oncocitoma renal Carcinoma de células renais Diagnóstico URO‐TC |
topic |
Renal oncocytoma Renal cell carcinoma Diagnosis URO‐CT Oncocitoma renal Carcinoma de células renais Diagnóstico URO‐TC |
description |
IntroductionOver the past few years, the increasing use of cross‐sectional imaging, including ultrasound and computed tomography imaging, resulted in an increase incidental diagnosis of renal tumors, especially small renal masses (<4cm). The knowledge that 30% of these masses may be benign, including oncocytomas led to the investigation for more effective methods of diagnosis in order to avoid overtreatment situations.ObjectivesThe authors decided to analyse and compare contrast enhancement patterns of oncocytomas and clear‐cell renal cell carcinoma (ccRCC) to predict histology.Material and methodsBetween 2004‐2015 we retrospectively identified 32 patients with either histological confirmation of renal oncocytoma (N=16) or ccRCC (N=16) who underwent percutaneous biopsy, total or partial nephrectomy. The relative attenuation of solid renal lesions and normal renal cortex was determined in the unenhanced and nephrographic phase. Statistical comparison was carried out by Mann‐Withney test.ResultsThe oncocytomas and cc‐RCC average size was 3.7cm [1.8 to 14] and 3.5cm [1.9 to 8.4], respectively. The average attenuation in the unenhanced phase was 33HU and 32HU, respectively. In nephrographic phase, the average contrast enhancement was 47.5 and 47.4H, respectively. In nephrographic phase, the attenuation difference between the oncocytomas and normal renal cortex was 43.5HU and the attenuation difference between the cc‐RCC and normal renal cortex was 59.7HU. These results were statistically significant (p<0.05).ConclusionsIn the nephrographic phase, URO‐CT reveals that oncocytomas have greater isodensity to the normal renal cortex compared to cc‐RCC. This finding can help us to determine which lesions we should biopsy or not. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-04-11T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.24915/aup.33.3.35 oai:oai.actaurologicaportuguesa.com:article/35 |
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https://doi.org/10.24915/aup.33.3.35 |
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oai:oai.actaurologicaportuguesa.com:article/35 |
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por |
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http://www.actaurologicaportuguesa.com/index.php/aup/article/view/35 https://doi.org/10.24915/aup.33.3.35 http://www.actaurologicaportuguesa.com/index.php/aup/article/view/35/5 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Associação Portuguesa de Urologia |
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Associação Portuguesa de Urologia |
dc.source.none.fl_str_mv |
Acta Urológica Portuguesa; Vol. 33 No. 3 (2016): Setembro-Dezembro; 98-103 Acta Urológica Portuguesa; v. 33 n. 3 (2016): Setembro-Dezembro; 98-103 2387-0419 2341-4022 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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