Clear cell renal cell carcinoma: identifying PTEN expression on multiphasic MDCT

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Pathology

Background:

• PTEN expression is a critical prognostic marker in clear cell renal cell carcinoma (ccRCC).
• Loss of PTEN expression correlates with poorer survival, higher Fuhrman grade, and increased lymph node metastasis.
• Non-invasive methods to predict PTEN status are valuable for treatment planning.

Purpose of the Study:

• To determine if multiphasic MDCT enhancement patterns can predict PTEN expression in ccRCC.
• To assess the diagnostic performance of imaging features in identifying PTEN-negative ccRCCs.

Main Methods:

• Retrospective analysis of 103 ccRCC cases with preoperative 4-phase renal mass MDCT.
• Computer-assisted analysis to measure relative attenuation in the corticomedullary phase.
• Logistic regression used to evaluate multiphasic enhancement for PTEN expression prediction.

Main Results:

• Both PTEN-positive and PTEN-negative ccRCCs peaked in the corticomedullary phase.
• PTEN-negative ccRCCs exhibited significantly higher relative corticomedullary phase attenuation (33.7 vs. 9.5, p=0.03).
• Relative corticomedullary phase attenuation achieved 84% accuracy, 100% specificity, and 83% negative predictive value for identifying PTEN expression.

Conclusions:

• Relative corticomedullary phase attenuation on multiphasic MDCT shows potential for identifying PTEN expression in ccRCC.
• Prospective validation is recommended to confirm these findings.