The role of perfusion computed tomography in the diagnosis of kidney cancer

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Abstract

Background: Imaging methods such as ultrasound, computed tomography (CT), positron emission tomography, and magnetic resonance imaging (MRI) play a leading role in the detection of kidney tumors. Renal CT is the standard for diagnosing renal cell carcinoma (RCC). Digital data on perfusion CT (PCT) parameters for the tumor zone and healthy tissue allow to determine normalized «i» values for each RCC parameter (BF – blood flow, BV – blood volume, MTT – mean transit time, TTP – time to peak).

Despite the long history of studying RCC, diagnostic methods, and imaging, CT and/or MRI do not have sufficient specificity. Based on the statistical analysis, PCT has great potential in diagnosing renal masses and may open new perspectives for optimizing surgical tactics due to its high information content in the differential diagnosis of benign and malignant renal masses.

Objective: Determination of the diagnostic value of PCT in optimizing surgical treatment tactics and assessing the functional capacity of the renal parenchyma in RCC.

Materials and methods: The study analyzed data from 119 patients (58.3 ± 12.6 years) with a confirmed diagnosis of RCC who underwent PCT before treatment and at 1 and 3 months after the start of therapy. Four perfusion parameters were evaluated for the diagnosis of RCC: BF, BV, MTT, and TTP.

Results: According to the analysis, 1 month after of treatment, patients (n=45) responding to therapy showed a decrease in BF and BV in tumor tissue (p<0.01). In the group of non-responders (n=34), changes in perfusion parameters were non-significant (p>0.05). In patients responding to therapy after 3 months, perfusion parameters continued to decline. The mean BF was 85.2±15.3 ml/100 g/min, and BV was 10.7±2.1 ml/100 g.

Conclusion: PCT has great potential and opens new perspectives in the diagnosis, assessment, and surgical management of RCC.

About the authors

A. V. Khasigov

North Ossetian State Medical Academy

Email: alan_hasigov@mail.ru
ORCID iD: 0000-0003-1103-4532
Russian Federation, Vladikavkaz

V. T. Tebiyev

North Ossetian State Medical Academy

Author for correspondence.
Email: tebiyevv@mail.ru
ORCID iD: 0009-0001-2173-8384
Russian Federation, Vladikavkaz

A. V. Timoshenkova

North Ossetian State Medical Academy

Email: colorsit21@mail.ru
Russian Federation, Vladikavkaz

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