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Differentiation of benign from malignant solid renal lesions using CT-based radiomics and machine learning: comparison with radiologist interpretation. Abdom Radiol (NY) 2023; 48:642-648. [PMID: 36370180 DOI: 10.1007/s00261-022-03735-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess the performance of a machine learning model trained with contrast-enhanced CT-based radiomics features in distinguishing benign from malignant solid renal masses and to compare model performance with three abdominal radiologists. METHODS Patients who underwent intra-operative ultrasound during a partial nephrectomy were identified within our institutional database, and those who had pre-operative contrast-enhanced CT examinations were selected. The renal masses were segmented from the CT images and radiomics features were derived from the segmentations. The pathology of each mass was identified; masses were labeled as either benign [oncocytoma or angiomyolipoma (AML)] or malignant [clear cell, papillary, or chromophobe renal cell carcinoma (RCC)] depending on the pathology. The data were parsed into a 70/30 train/test split and a random forest machine learning model was developed to distinguish benign from malignant lesions. Three radiologists assessed the cohort of masses and labeled cases as benign or malignant. RESULTS 148 masses were identified from the cohort, including 50 benign lesions (23 AMLs, 27 oncocytomas) and 98 malignant lesions (23 clear cell RCC, 44 papillary RCC, and 31 chromophobe RCCs). The machine learning algorithm yielded an overall accuracy of 0.82 for distinguishing benign from malignant lesions, with an area under the receiver operating curve of 0.80. In comparison, the three radiologists had significantly lower accuracies (p = 0.02) ranging from 0.67 to 0.75. CONCLUSION A machine learning model trained with CT-based radiomics features can provide superior accuracy for distinguishing benign from malignant solid renal masses compared to abdominal radiologists.
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Massa'a RN, Stoeckl EM, Lubner MG, Smith D, Mao L, Shapiro DD, Abel EJ, Wentland AL. Differentiation of benign from malignant solid renal lesions with MRI-based radiomics and machine learning. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:2896-2904. [PMID: 35723716 DOI: 10.1007/s00261-022-03577-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Solid renal masses are often indeterminate for benignity versus malignancy on magnetic resonance imaging. Such masses are typically evaluated with either percutaneous biopsy or surgical resection. Percutaneous biopsy can be non-diagnostic and some surgically resected lesions are inadvertently benign. PURPOSE To assess the performance of ten machine learning (ML) algorithms trained with MRI-based radiomics features in distinguishing benign from malignant solid renal masses. METHODS Patients with solid renal masses identified on pre-intervention MRI were curated from our institutional database. Masses with a definitive diagnosis via imaging (for angiomyolipomas) or via biopsy or surgical resection (for oncocytomas or renal cell carcinomas) were selected. Each mass was segmented for both T2- and post-contrast T1-weighted images. Radiomics features were derived from the segmented masses for each imaging sequence. Ten ML algorithms were trained with the radiomics features gleaned from each MR sequence, as well as the combination of MR sequences. RESULTS In total, 182 renal masses in 160 patients were included in the study. The support vector machine algorithm trained on radiomics features from T2-weighted images performed superiorly, with an accuracy of 0.80 and an area under the curve (AUC) of 0.79. Linear discriminant analysis (accuracy = 0.84 and AUC = 0.77) and logistic regression (accuracy = 0.78 and AUC = 0.78) algorithms trained on T2-based radiomics features performed similarly. ML algorithms trained on radiomics features from post-contrast T1-weighted images or the combination of radiomics features from T2- and post-contrast T1-weighted images yielded lower performance. CONCLUSION Machine learning models trained with radiomics features derived from T2-weighted images can provide high accuracy for distinguishing benign from malignant solid renal masses. CLINICAL IMPACT Machine learning models derived from MRI-based radiomics features may improve the clinical management of solid renal masses and have the potential to reduce the frequency with which benign solid renal masses are biopsied or surgically resected.
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Affiliation(s)
- Ruben Ngnitewe Massa'a
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Elizabeth M Stoeckl
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Meghan G Lubner
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - David Smith
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Lu Mao
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Daniel D Shapiro
- Department of Urology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - E Jason Abel
- Department of Urology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Andrew L Wentland
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Avenue, Madison, WI, 53792, USA. .,Department of Medical Physics, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA. .,Department of Biomedical Engineering, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA.
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Said D, Hectors SJ, Wilck E, Rosen A, Stocker D, Bane O, Beksaç AT, Lewis S, Badani K, Taouli B. Characterization of solid renal neoplasms using MRI-based quantitative radiomics features. Abdom Radiol (NY) 2020; 45:2840-2850. [PMID: 32333073 DOI: 10.1007/s00261-020-02540-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE To assess the diagnostic value of magnetic resonance imaging (MRI)-based radiomics features using machine learning (ML) models in characterizing solid renal neoplasms, in comparison/combination with qualitative radiologic evaluation. METHODS Retrospective analysis of 125 patients (mean age 59 years, 67% males) with solid renal neoplasms that underwent MRI before surgery. Qualitative (signal and enhancement characteristics) and quantitative radiomics analyses (histogram and texture features) were performed on T2-weighted imaging (WI), T1-WI pre- and post-contrast, and DWI. Mann-Whitney U test and receiver-operating characteristic analysis were used in a training set (n = 88) to evaluate diagnostic performance of qualitative and radiomics features for differentiation of renal cell carcinomas (RCCs) from benign lesions, and characterization of RCC subtypes (clear cell RCC [ccRCC] and papillary RCC [pRCC]). Random forest ML models were developed for discrimination between tumor types on the training set, and validated on an independent set (n = 37). RESULTS We assessed 104 RCCs (51 ccRCC, 29 pRCC, and 24 other subtypes) and 21 benign lesions in 125 patients. Significant qualitative and quantitative radiomics features (area under the curve [AUC] between 0.62 and 0.90) were included for ML analysis. Models with best diagnostic performance on validation sets showed AUC of 0.73 (confidence interval [CI] 0.5-0.96) for differentiating RCC from benign lesions (using combination of qualitative and radiomics features); AUC of 0.77 (CI 0.62-0.92) for diagnosing ccRCC (using radiomics features), and AUC of 0.74 (CI 0.53-0.95) for diagnosing pRCC (using qualitative features). CONCLUSION ML models incorporating MRI-based radiomics features and qualitative radiologic assessment can help characterize renal masses.
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Affiliation(s)
- Daniela Said
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Radiology, Universidad de los Andes, Santiago, Chile
| | - Stefanie J Hectors
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Eric Wilck
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ally Rosen
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Radiology, Long Island School of Medicine, NYU-Winthrop Hospital, Mineola, NY, USA
| | - Daniel Stocker
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute of Interventional and Diagnostic Radiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Octavia Bane
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alp Tuna Beksaç
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sara Lewis
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ketan Badani
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bachir Taouli
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Yano M, Fowler KJ, Srisuwan S, Salter A, Siegel CL. Quantitative multiparametric MR analysis of small renal lesions: correlation with surgical pathology. Abdom Radiol (NY) 2018; 43:3390-3399. [PMID: 29691619 DOI: 10.1007/s00261-018-1612-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The purpose of the study is to evaluate the utility of apparent diffusion coefficient (ADC), chemical shift signal intensity index (SII), and contrast enhancement in distinguishing between benign lesions and renal cell carcinoma (RCC) and between subtypes of renal lesions. METHODS This retrospective study included 98 renal lesions (≤ 3 cm) on MRI with correlative surgical pathology. Scanner field strength, lesion location, and size were recorded. Two readers blinded to surgical pathology independently measured ADC ratio (ADC lesion/ADC non-lesion kidney), SII, and absolute/relative enhancement in the corticomedullary and nephrographic phases of contrast. RESULTS There were 76 malignant and 22 benign lesions. 42 RCC were clear cell (ccRCC), 19 papillary (pRCC), 5 chromophobe (cbRCC). Benign lesions included both solid and cystic lesions. Interreader agreement for all variables was good-excellent (ICC 0.70-0.91). There was no difference in ADC or SII between benign and malignant lesions. There was greater absolute corticomedullary enhancement of benign versus malignant lesions (150.0 ± 111.5 vs. 81.1 ± 74.8, p = 0.0115), which did not persist when excluding pRCC. For lesion subtype differentiation, ADCratio for pRCC was lower than benign lesions (0.74 ± 0.35 vs. 1.03 ± 0.46, p = 0.0246). ccRCC demonstrated greater SII than other RCC (0.09 ± 0.22 vs. 0.001 ± 0.26, p = 0.0412). Oncocytomas and angiomyolipoma (AML) showed greater absolute corticomedullary enhancement than ccRCC and pRCC (145.6 ± 65.2 vs. 107.2 ± 85.3, p = 0.043 and 186.2 ± 93.9 vs. 37.6 ± 35.3, p = 0.0108), respectively. CONCLUSIONS While corticomedullary-phase enhancement was a differentiating feature, quantitative metrics from diffusion and chemical shift imaging cannot reliably differentiate benign from malignant lesions. Quantitative assessment may be useful in differentiating some benign and malignant lesion subtypes.
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Affiliation(s)
- Motoyo Yano
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., Campus Box 8131, Saint Louis, MO, 63110, USA.
| | - Kathryn J Fowler
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., Campus Box 8131, Saint Louis, MO, 63110, USA
| | - Santip Srisuwan
- Department of Radiology, Bangkok Hospital Chiang Mai, 88/8 Nong Pa Khrang, Muang Chiang Mai, 50000, Thailand
| | - Amber Salter
- Division of Biostatistics, Washington University School of Medicine, 660 Euclid Ave., Campus Box 8067, St. Louis, MO, 63110-1093, USA
| | - Cary L Siegel
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., Campus Box 8131, Saint Louis, MO, 63110, USA
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Wang K, Zhang YL, Lin CH, Liu DF, Men CP, Wang JM, Gao ZL. Application of self-retaining bidirectional barbed absorbable suture in retroperito- neoscopic partial nephrectomy. Int Braz J Urol 2014; 40:220-4. [PMID: 24856489 DOI: 10.1590/s1677-5538.ibju.2014.02.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 07/25/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the safety and feasibility of self-retaining bidirectional barbed absorbable suture application in retroperitoneoscopic partial nephrectomy. MATERIALS AND METHODS From Sep 2011 and Aug 2012, 76 cases of retroperitoneoscopic partial nephrectomy were performed at our hospital. The patients were divided into two groups: self-retaining barbed suture (SRBS) group (n = 36) and non-SRBS group (n = 40). There was no significant difference in age, sex, tumor size and location between the two groups. Clinical data and outcomes were analyzed retrospectively. RESULTS All 76 cases of retroperitoneoscopic partial nephrectomy were successfully performed, without conversion to open surgery or serious intraoperative complications. In the SRBS group, the suture time, warm ischemia time and operation blood loss were significantly shorter than that of non-SRBS group (p < 0.01), and operation time and hospital stay were shorter than that of non-SRBS group (p < 0.05). CONCLUSIONS The application of self-retaining bidirectional barbed absorbable suture in retroperitoneoscopic partial nephrectomy could shorten suture time and warm ischemia time, with good safety and feasibility, worthy of being used in clinic.
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Affiliation(s)
- Ke Wang
- Department of Urology, Yantai Yuhuangding Hospital , Yantai 264000, China
| | - Yu-Lian Zhang
- Department of Gynecology (ZYL), Yantai Yuhuangding Hospital , Yantai 264000, China
| | - Chun-Hua Lin
- Department of Urology, Yantai Yuhuangding Hospital , Yantai 264000, China
| | - Dong-Fu Liu
- Department of Urology, Yantai Yuhuangding Hospital , Yantai 264000, China
| | - Chang-Ping Men
- Department of Urology, Yantai Yuhuangding Hospital , Yantai 264000, China
| | - Jian-Ming Wang
- Department of Urology, Yantai Yuhuangding Hospital , Yantai 264000, China
| | - Zhen-Li Gao
- Department of Urology, Yantai Yuhuangding Hospital , Yantai 264000, China
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Vargas HA, Chaim J, Lefkowitz RA, Lakhman Y, Zheng J, Moskowitz CS, Sohn MJ, Schwartz LH, Russo P, Akin O. Renal cortical tumors: use of multiphasic contrast-enhanced MR imaging to differentiate benign and malignant histologic subtypes. Radiology 2012; 264:779-88. [PMID: 22829683 DOI: 10.1148/radiol.12110746] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE To investigate the use of quantitative multiphasic contrast material-enhanced magnetic resonance (MR) imaging in differentiating between common benign and malignant histologic subtypes of renal cortical tumors. MATERIALS AND METHODS The institutional review board waived informed consent and approved this retrospective HIPAA-compliant study of 138 patients who underwent preoperative contrast-enhanced MR imaging during the period of January 2004-December 2008. At surgery, 152 renal tumors were identified (77 clear cell, 22 papillary, 18 chromophobe, and 10 unclassified carcinomas; 16 oncocytomas; nine angiomyolipomas). Three readers independently identified and measured the most-enhanced area in each tumor and placed corresponding regions of interest in similar positions on images from the precontrast, corticomedullary, nephrographic, and excretory phases. The percentage change in signal intensity (%SI change) between precontrast imaging and each postcontrast phase was calculated. Interreader agreement was evaluated by using the overall concordance correlation coefficient (OCC). A linear mixed-effects model was used to estimate and compare the trajectories of the means of log %SI change across all phases between the six histologic subtypes. RESULTS Interreader agreement was substantial to almost perfect (OCC, 0.77-0.88). The %SI change differed significantly between clear cell carcinomas and papillary and chromophobe carcinomas in all phases of enhancement (P < .0001-.0120). In addition, %SI change was significantly higher in angiomyolipomas than in clear cell carcinomas, but only in the corticomedullary phase (P = .0231). Enhancement did not differ significantly between clear cell carcinoma and oncocytoma in any phase (P = .2081-.6000). CONCLUSION Quantitative multiphase contrast-enhanced MR imaging offers a widely available, reproducible method to characterize several histologic subtypes of renal cortical tumors, although it does not aid differentiation between clear cell carcinomas and oncocytomas.
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Affiliation(s)
- Hebert Alberto Vargas
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278E, New York, NY 10065, USA.
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Wei H, Ke HL, Lin J, Shete S, Wood CG, Hildebrandt MAT. MicroRNA target site polymorphisms in the VHL-HIF1α pathway predict renal cell carcinoma risk. Mol Carcinog 2012; 53:1-7. [PMID: 22517515 DOI: 10.1002/mc.21917] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 03/19/2012] [Accepted: 03/28/2012] [Indexed: 12/19/2022]
Abstract
Renal cell carcinoma (RCC) accounts for ∼4% of all human malignancies and is the 9th leading cause of male cancer death in the United States. The purpose of this study was to determine the effect of variation within microRNA (miRNA)-binding sites of genes in the VHL-HIF1α pathway on RCC risk. We identified 429 miRNA-binding site single-nucleotide polymorphisms (SNPs) in 102 pathway genes and assessed 53 tagging-SNPs for 31 of these genes for risk in a case-control study consisting of 894 RCC cases and 1,516 controls. Results showed that five SNPs were significantly associated with RCC risk. The most significant finding was rs743409 in MAPK1. Under the additive model, the variant was associated with a 10% risk reduction (OR: 0.90, 95% CI, 0.77-0.98). Other significant findings were for SNPs in CDCP1, TFRC, and DEC1. Cumulative effects analysis showed that subjects carrying four or five unfavorable genotypes had a 2.14-fold increase in risk (95% CI, 1.03-4.43, P = 0.04) than those with no unfavorable genotypes. Potential higher-order gene-gene interactions were identified and categorized subjects into different risk groups. The OR of the high-risk group defined by two SNPs: CDCP1:rs6773576 (GG) and DEC1:rs10982724 (GG) was 4.46 times higher than that of low-risk reference group (95% CI, 1.31-15.08). Overall, our study provides the first evidence supporting a connection between miRNA-binding site SNPs within the VHL-HIF1α pathway and RCC risk. These novel genetic risk factors might help identify individuals at high risk to enable detection of tumors at an early, curable stage.
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Affiliation(s)
- Hua Wei
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Klatte T, Mauermann J, Heinz-Peer G, Waldert M, Weibl P, Klingler HC, Remzi M. Perioperative, oncologic, and functional outcomes of laparoscopic renal cryoablation and open partial nephrectomy: a matched pair analysis. J Endourol 2011; 25:991-7. [PMID: 21568698 DOI: 10.1089/end.2010.0615] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To directly compare perioperative, oncologic, and functional outcomes of laparoscopic renal cryoablation and open partial nephrectomy using a matched pair analysis. PATIENTS AND METHODS A total of 41 patients who underwent laparoscopic cryoablation for an incidental, solid clinical T(1a)N(0)M(0) renal tumor were matched with 82 patients who received partial nephrectomy in cold ischemia, using optimal matching based on propensity scores, which were created on the basis of preoperative aspects and dimensions used for an anatomic classification of renal tumors (PADUA) score, preoperative glomerular filtration rate, age-adjusted Charlson comorbidity index, and sex. Median follow-up was 33.6 months. RESULTS No differences in the overall incidence of complications (cryoablation, 20%; partial nephrectomy, 17%; P=0.739) and grade of complications (P=0.424) were observed. After cryoablation, local recurrence developed in four patients with renal-cell carcinoma (n=35) after a median duration of 14 months (range 6-18 mos), but none after partial nephrectomy. The 3-year recurrence-free survival probabilities after laparoscopic renal cryoablation vs open partial nephrectomy were 83% vs 100%, respectively (P=0.015). The average decrease of estimated glomerular filtration rate during follow-up was 7.8±3.1 mL/min/1.73 m(2) after laparoscopic cryoablation and 9.8±2.3 mL/min/1.73 m(2) after open partial nephrectomy, which was not statistically significant (P=0.602). CONCLUSIONS Perioperative complications and renal functional outcomes of laparoscopic cryoablation and open partial nephrectomy are similar; however, laparoscopic cryoablation confers a substantially higher local recurrence risk of about 17% after 3 years. Therefore, laparoscopic renal cryoablation should be reserved for high-risk patients with decreased life expectancy. Careful patient counseling is advocated. Study limitations include the small sample size, the lack of randomization, and the short follow-up.
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Affiliation(s)
- Tobias Klatte
- Department of Urology, Medical University of Vienna, Vienna, Austria.
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Suson KD, Richard H, Phelan MW. Cryoablation of Renal Fossa Recurrence After Radical Nephrectomy. J Endourol 2011; 25:559-62. [DOI: 10.1089/end.2010.0463] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Kristina D. Suson
- Division of Urology, University of Maryland Medical Center, Baltimore, Maryland
| | - Howard Richard
- Division of Vascular and Interventional Radiology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Michael W. Phelan
- Division of Urology, University of Maryland Medical Center, Baltimore, Maryland
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Tsivian M, Mouraviev V, Albala DM, Caso JR, Robertson CN, Madden JF, Polascik TJ. Clinical predictors of renal mass pathological features. BJU Int 2010; 107:735-740. [PMID: 21054752 DOI: 10.1111/j.1464-410x.2010.09629.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Matvey Tsivian
- Division of Urology, Department of SurgeryDepartment of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Vladimir Mouraviev
- Division of Urology, Department of SurgeryDepartment of Pathology, Duke University Medical Center, Durham, NC, USA
| | - David M Albala
- Division of Urology, Department of SurgeryDepartment of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Jorge R Caso
- Division of Urology, Department of SurgeryDepartment of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Cary N Robertson
- Division of Urology, Department of SurgeryDepartment of Pathology, Duke University Medical Center, Durham, NC, USA
| | - John F Madden
- Division of Urology, Department of SurgeryDepartment of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Thomas J Polascik
- Division of Urology, Department of SurgeryDepartment of Pathology, Duke University Medical Center, Durham, NC, USA
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Ritchie RW, Leslie TA, Turner GD, Roberts IS, D’Urso L, Collura D, Demarchi A, Muto G, Sullivan ME. Laparoscopic high-intensity focused ultrasound for renal tumours: a proof of concept study. BJU Int 2010; 107:1290-6. [DOI: 10.1111/j.1464-410x.2010.09620.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Setlik DE, McCluskey KM, McDavit JA. Best cases from the AFIP: renal cell carcinoma manifesting as a solitary bone metastasis. Radiographics 2010; 29:2184-9. [PMID: 19926770 DOI: 10.1148/rg.297095021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Daria E Setlik
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
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Sperati CJ, Alachkar N, Rodriguez R, Haas M, Choi MJ. Incidental discovery of a renal cell carcinoma on native kidney biopsy. Am J Kidney Dis 2009; 56:175-80. [PMID: 19880231 DOI: 10.1053/j.ajkd.2009.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Accepted: 08/25/2009] [Indexed: 11/11/2022]
Affiliation(s)
- C John Sperati
- Department of Medicine, Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
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Abstract
The increasing incidence of renal cell carcinoma over the past 2 decades can be partly explained by the expanding use of abdominal imaging. As a result, the most incident renal cancers today are small, localized, and asymptomatic. However, the well-documented rise in all stages of RCC calls into question the nature of these asymptomatic lesions. The expected "screening effect" of detecting RCC when it is small and localized, with subsequent decreases in disease-specific mortality, has not been observed. Disease-specific mortality is actually rising, especially in African American patients. Effective interventions aimed at reducing obesity, hypertension, and smoking may help in reducing the incidence of RCC in the future.
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Abstract
The detection of incidental and asymptomatic renal cortical neoplasms has concomitantly increased with radiographic imaging use. The gold standard for treating small renal tumors includes open and laparoscopic partial nephrectomy. Ablative renal procedures intend to duplicate the excellent oncologic outcomes of partial nephrectomy, while decreasing complications and shortening hospitalization time and convalescence. Only short and medium-term data are available, but ablation with cryotherapy or radiofrequency probes may achieve these goals. Ablation also offers the advantages of a minimally invasive surgical approach, with a significantly lower complication rate than partial nephrectomy. Ablated lesions are typically left in situ. Leaving potentially malignant tissues in place, albeit in a nonviable condition, certainly represents a major change in surgical thinking processes. This article reviews the status of cryoablation and radiofrequency ablation, the two ablative modalities currently available for clinical application.
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Okubo Y, Yonese J, Kawakami S, Yamamoto S, Komai Y, Takeshita H, Ishikawa Y, Fukui I. Obstinate cough as a sole presenting symptom of non-metastatic renal cell carcinoma. Int J Urol 2007; 14:854-5. [PMID: 17760755 DOI: 10.1111/j.1442-2042.2007.01832.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Renal cell carcinoma (RCC) causes many kinds of symptoms such as hypercalcemia, hypertension, polycythemia and fever. Here we describe a rare case of RCC presenting with a persistent cough. After radical nephrectomy, the obstinate cough disappeared. When the tumor recurred locally, the cough also recurred. Furthermore, the cough disappeared completely again after the removal of the recurrent tumor. Although all the clinical findings suggested that the RCC caused the cough, we could not identify a specific humoral substance responsible for the cough.
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Affiliation(s)
- Yuhei Okubo
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
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