caa a22 4500 605494509 CHVBK 20210128100526.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00261-015-0531-8 doi (NATIONALLICENCE)springer-10.1007/s00261-015-0531-8 CT prediction of the Fuhrman grade of clear cell renal cell carcinoma (RCC): towards the development of computer-assisted diagnostic method [Elektronische Daten] [Hannu Huhdanpaa, Darryl Hwang, Steven Cen, Brian Quinn, Megha Nayyar, Xuejun Zhang, Frank Chen, Bhushan Desai, Gangning Liang, Inderbir Gill, Vinay Duddalwar] Purpose: There are distinct quantifiable features characterizing renal cell carcinomas on contrast-enhanced CT examinations, such as peak tumor enhancement, tumor heterogeneity, and percent contrast washout. While qualitative visual impressions often suffice for diagnosis, quantitative metrics if developed and validated can add to the information available from standard of care diagnostic imaging. The purpose of this study is to assess the use of quantitative enhancement metrics in predicting the Fuhrman grade of clear cell RCC. Materials and methods: 65 multiphase CT examinations with clear cell RCCs were utilized, 44 tumors with Fuhrman grades 1 or 2 and 21 tumors with grades 3 or 4. After tumor segmentation, the following data were extracted: histogram analysis of voxel-based whole lesion attenuation in each phase, enhancement and washout using mean, median, skewness, kurtosis, standard deviation, and interquartile range. Results: Statistically significant difference was observed in 4 measured parameters between grades 1-2 and grades 3-4: interquartile range of nephrographic attenuation values, standard deviation of absolute enhancement, as well as interquartile range and standard deviation of residual nephrographic enhancement. Interquartile range of nephrographic attenuation values was 292.86 HU for grades 1-2 and 241.19 HU for grades 3-4 (p value 0.02). Standard deviation of absolute enhancement was 41.26 HU for grades 1-2 and 34.66 HU for grades 3-4 (p value 0.03). Interquartile range was 297.12 HU for residual nephrographic enhancement for grades 1-2 and 235.57 HU for grades 3-4 (p value 0.02), and standard deviation of the same was 42.45 HU for grades 1-2 and 37.11 for grades 3-4 (p value 0.04). Conclusion: Our results indicate that absolute enhancement is more heterogeneous for lower grade tumors and that attenuation and residual enhancement in nephrographic phase is more heterogeneous for lower grade tumors. This represents an important step in devising a predictive non-invasive model to predict the nucleolar grade. Springer Science+Business Media New York, 2015 Renal cell carcinoma nationallicence Quantitative imaging nationallicence Computer-assisted diagnosis nationallicence Computed tomography (CT) nationallicence Huhdanpaa Hannu Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut Hwang Darryl Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut Cen Steven Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut Quinn Brian Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut Nayyar Megha Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut Zhang Xuejun Viterbi School of Engineering, University of Southern California, Los Angeles, USA aut Chen Frank Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut Desai Bhushan Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut Liang Gangning Department of Urology, University of Southern California, 1441 Eastlake Ave, NOR 7416, 9003, Los Angeles, CA, USA aut Gill Inderbir Department of Urology, University of Southern California, 1441 Eastlake Ave, NOR 7416, 9003, Los Angeles, CA, USA aut Duddalwar Vinay Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/8(2015-10-01), 3168-3174 0942-8925 40:8<3168 2015 40 261 https://doi.org/10.1007/s00261-015-0531-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0531-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Huhdanpaa Hannu Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Hwang Darryl Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Cen Steven Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Quinn Brian Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Nayyar Megha Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Zhang Xuejun Viterbi School of Engineering, University of Southern California, Los Angeles, USA aut NATIONALLICENCE 700 1- Chen Frank Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Desai Bhushan Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Liang Gangning Department of Urology, University of Southern California, 1441 Eastlake Ave, NOR 7416, 9003, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Gill Inderbir Department of Urology, University of Southern California, 1441 Eastlake Ave, NOR 7416, 9003, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Duddalwar Vinay Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, 90033, Los Angeles, CA, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/8(2015-10-01), 3168-3174 0942-8925 40:8<3168 2015 40 261