We aimed to assess whether clear cell renal cell carcinoma (ccRCC) can be differentiated from renal oncocytoma (RO) on a contrast-enhanced ultrasound (CEUS).
Between January 2021 and October 2022, we retrospectively queried and analyzed our prospectively maintained dataset. Renal mass features were scrutinized with conventional ultrasound imaging (CUS) and CEUS. All lesions were confirmed by histopathologic diagnoses after nephron-sparing surgery (NSS). A multivariable analysis was performed to identify the potential predictors of ccRCC. The area under the curve (AUC) was depicted in order to assess the diagnostic accuracy of the multivariable model.
A total of 126 renal masses, including 103 (81.7%) ccRCC and 23 (18.3%) RO, matched our inclusion criteria. Among these two groups, we found significant differences in terms of enhancement (homogeneous vs. heterogeneous) (p < 0.001), wash-in (fast vs. synchronous/slow) (p = 0.004), wash-out (fast vs. synchronous/slow) (p = 0.001), and rim-like enhancement (p < 0.001). On the multivariate logistic regression, heterogeneous enhancement (OR: 19.37; p = <0.001) and rim-like enhancement (OR: 3.73; p = 0.049) were independent predictors of ccRCC. Finally, these two variables had an AUC of 82.5% and 75.3%, respectively.
Diagnostic imaging for presurgical planning is crucial in the choice of either conservative or radical management. CEUS, with its unique features, revealed its usefulness in differentiating ccRCC from RO.
Journal of clinical medicine. 2023 Apr 23*** epublish ***
Antonio Tufano, Costantino Leonardo, Chiara Di Bella, Giuseppe Lucarelli, Vincenzo Dolcetti, Piervito Dipinto, Flavia Proietti, Rocco Simone Flammia, Umberto Anceschi, Sisto Perdonà, Giorgio Franco, Alessandro Sciarra, Giovanni Battista Di Pierro, Vito Cantisani
Department of Maternal-Child and Urological Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, 00162 Rome, Italy., Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00162 Rome, Italy., Department of Urology, IRCCS "Regina Elena" National Cancer Institute, 00144 Rome, Italy., Fondazione "G. Pascale" IRCCS, 80131 Naples, Italy.