Computed tomography imaging characteristics of clear cell papillary renal cell carcinoma

Diagnostic value of imaging in patients with clear cell papillary renal cell carcinoma: A case series and literature review

Clear cell papillary renal cell carcinoma (CCPRCC) is a newly classified renal cell carcinoma with a low degree of malignancy. Its imaging features have not been studied deeply. Therefore, we reviewed the imaging features of CCPRCC. Solid CCPRCC shows high echo or isoecho mass on conventional ultrasound. Contrast enhanced ultrasound shows "fast forward and slow backward, uneven high enhancement". Computed tomography shows high enhancement and maximum enhancement in the cortical-medullary phase. Magnetic resonance imaging shows slightly low T1WI and high T2WI. This article aims to improve the understanding of CCPRCC by clinical radiologists and promote the accurate.

Renal Cell Carcinoma in End-Stage Renal Disease: A Review and Update

Renal cell carcinoma (RCC) occurring in the setting of end-stage renal disease (ESRD) shows unique clinicopathological characteristics. The two most frequent types of ESRD-associated RCC are acquired cystic kidney disease-associated renal cell carcinoma (ACKD-RCC) and clear-cell papillary renal cell carcinoma (ccpRCC). Other types of RCC also occur in ESRD, albeit with different frequencies from the non-ESRD general population. The histological features of RCC do not vary in the setting of ESRD vs. non-ESRD, yet other findings, such as multifocality and multiple tumor types, are more frequent in ESRD. Studies have generated novel and important knowledge of the etiology, epidemiology, diagnosis, treatment, immunophenotype, and molecular characteristics of ESRD-associated RCC. Knowledge of these data is important for both pathologists and other physicians who may encounter ESRD patients with RCC. This review presents a comprehensive summary and update of the literature on RCC in ESRD, with a focus on the two most frequent types, ACKD-RCC and ccpRCC.

Consensus Statement on Urinary Stone Treatment During A Pandemic: A Delphi Process from the Endourological Society TOWER Research Initiative

INTRODUCTION

The COVID-19 pandemic has had a significant impact on the care of patients with urolithiasis. Recommendations and prioritization of endourologic surgical procedures vary among regions and a comprehensive overall international directive is needed. We used the Delphi method to obtain international consensus on managing urolithiasis patients during the pandemic.

METHODS

A three-round Delphi process was used to elicit expert consensus (53 global key opinion leaders within the Endourological Society from 36 countries) on an extensive survey on management of endourologic patients in a pandemic. Questions addressed general management, inpatient and outpatient procedures, clinic visits, follow-up care and best practices for suspension and resumption of routine care.

RESULTS

Consensus was achieved in 64/84 (76%) questions. Key consensus findings included: consultations should be delivered remotely when possible. Invasive surgical procedures for urolithiasis patients should be reserved for high-risk situations (infection, renal failure, etc.). To prevent aerosolization, spinal anesthesia is preferred over general, whenever feasible. Treatment of asymptomatic renal stones should be deferred. Primary definitive treatment of obstructing or symptomatic stones (both renal and ureteral) is preferred over temporizing drainage. Extracorporeal shock wave lithotripsy should be continued for obstructive ureteral stones. There was consensus on treatment modalities and drainage strategies depending on location and size of the stone.

CONCLUSION

International endourologist members of the Endourological Society participated in this Delphi initiative to provide expert consensus on management of urolithiasis during a pandemic. These results can be applied currently and during a future pandemic.

CT-based multi-phase Radiomic models for differentiating clear cell renal cell carcinoma

Background

The aim of the study is to compare the diagnostic value of models that based on a set of CT texture and non-texture features for differentiating clear cell renal cell carcinomas(ccRCCs) from non-clear cell renal cell carcinomas(non-ccRCCs).

Methods

A total of 197 pathologically proven renal tumors were divided into ccRCC(n = 143) and non-ccRCC (n = 54) groups. The 43 non-texture features and 296 texture features that extracted from the 3D volume tumor tissue were assessed for each tumor at both Non-contrast Phase, NCP; Corticomedullary Phase, CMP; Nephrographic Phase, NP and Excretory Phase, EP. Texture-score were calculated by the Least Absolute Shrinkage and Selection Operator (LASSO) to screen the most valuable texture features. Model 1 contains the three most distinctive non-texture features with p < 0.001, Model 2 contains texture scores, and Model 3 contains the above two types of features.

Results

The three models shown good discrimination of the ccRCC from non-ccRCC in NCP, CMP, NP, and EP. The area under receiver operating characteristic curve (AUC)values of the Model 1, Model 2, and Model 3 in differentiating the two groups were 0.748–0.823, 0.776–0.887 and 0.864–0.900, respectively. The difference in AUC between every two of the three Models was statistically significant (p < 0.001).

Conclusions

The predictive efficacy of ccRCC was significantly improved by combining non-texture features and texture features to construct a combined diagnostic model, which could provide a reliable basis for clinical treatment options.