A quantitative assessment of the vascularization of the different histological types of renal cell carcinoma by multislice computed tomography

Abstract

The research purpose was a study of the quantitative indices of the vascularization of different histological variants of renal cell carcinoma by multislice computed tomography (MSCT).
Materials and methods. MSCT data of 46 patients (20 women, 26 men at the age of 48—64 years) with different variants of the renal cell carcinoma (RCC) over a period of 2003—2006 were analysed retrospectively. Depending on the RCC histologic type the patients were divided into 2 groups. Patients with clear cell variant of RCC were included in the first group (n=31), the patients with other histological types of RCC formed the second one (n=15). A comparison of the quantitative indices of the vascularization of tumors in the chosen groups of patients on the basis of estimation of contrasting medication accumulation in the arterial and parenchymatous phases of MSCT was made. To investigate a degree of accumulation of the contrasting medication in the tumor («gain constant» — GC) a method of the standardized measuring of the contrasting medication accumulation was used. (A J. Ruppert-Kohlmayr et al, 2004).
Results. In the first group of patients the GC averaged 4,8 (2,1—13,1) in the arterial phase of the study whereas in the second group of patients the given index amounted 2,4 (1,0—2,8). In the parenchymatous phase of CT-study the mean «gain constants» for the first and second groups mounted, accordingly 3,0 and 2,2. Under the statistic analysis of the obtained data, the reliable differences between the chosen groups of patients according to the values of the «gain constant» in 2 phases of CT-study were revealed.
Conclusion. The use of the method of quantitative measuring of the contrasting medication accumulation in the kidney tumors when realizing CT-examination allows avoiding errors in determination of the densitometric indices of the tumor node caused by an incorrect choice of the time administration of the contrasting medication and by individual features of the patient. «Gain constant» may be used as a criterion of the differential diagnosis between clear cell variant of RCC and other histological variants of kidney cancer.