Department of Urology, AMC University Hospital, Amsterdam, The Netherlands.
Department of Urology, AMC University Hospital, Amsterdam, The Netherlands; Department of Urology, IR4M Institut de Cancerologie Gustave Roussy, Paris, France.
J Urol. 2016 May;195(5):1578-1585. doi: 10.1016/j.juro.2015.12.072. Epub 2015 Dec 21.
We determine the ability of percutaneous needle based optical coherence tomography to differentiate renal masses by using the attenuation coefficient (μOCT, mm(-1)) as a quantitative measure.
Percutaneous needle based optical coherence tomography of the kidney was performed in patients presenting with a solid renal mass. A pathology specimen was acquired in the form of biopsies and/or a resection specimen. Optical coherence tomography results of 40 patients were correlated to pathology results of the resected specimens in order to derive μOCT values corresponding with oncocytoma and renal cell carcinoma, and with the 3 main subgroups of renal cell carcinoma. The sensitivity and specificity of optical coherence tomography in differentiating between oncocytoma and renal cell carcinoma were assessed through ROC analysis.
The median μOCT of oncocytoma (3.38 mm(-1)) was significantly lower (p=0.043) than the median μOCT of renal cell carcinoma (4.37 mm(-1)). ROC analysis showed a μOCT cutoff value of greater than 3.8 mm(-1) to yield a sensitivity, specificity, positive predictive value and negative predictive value of 86%, 75%, 97% and 37%, respectively, to differentiate between oncocytoma and renal cell carcinoma. The area under the ROC curve was 0.81. Median μOCT was significantly lower for oncocytoma vs clear cell renal cell carcinoma (3.38 vs 4.36 mm(-1), p=0.049) and for oncocytoma vs papillary renal cell carcinoma (3.38 vs 4.79 mm(-1), p=0.027).
We demonstrated that the μOCT is significantly higher in renal cell carcinoma vs oncocytoma, with ROC analysis showing promising results for their differentiation. This demonstrates the potential of percutaneous needle based optical coherence tomography to help in the differentiation of renal masses, thus warranting ongoing research.
我们通过使用衰减系数（μOCT，mm（-1））作为定量测量指标，确定经皮针基光相干断层扫描对区分肾脏肿块的能力。
对因实性肾脏肿块就诊的患者进行经皮针基光相干断层扫描。活检和/或切除标本获取病理标本。将 40 例患者的光相干断层扫描结果与切除标本的病理结果相关联，以得出与嗜酸细胞瘤和肾细胞癌以及肾细胞癌的 3 个主要亚组相对应的μOCT 值。通过 ROC 分析评估光相干断层扫描在区分嗜酸细胞瘤和肾细胞癌方面的敏感性和特异性。
嗜酸细胞瘤（3.38 mm（-1））的中位数μOCT明显低于肾细胞癌（4.37 mm（-1））（p=0.043）。ROC 分析显示，μOCT 截断值大于 3.8 mm（-1），可分别产生 86%、75%、97%和 37%的敏感性、特异性、阳性预测值和阴性预测值，以区分嗜酸细胞瘤和肾细胞癌。ROC 曲线下面积为 0.81。与透明细胞肾细胞癌（3.38 对 4.36 mm（-1），p=0.049）和乳头状肾细胞癌（3.38 对 4.79 mm（-1），p=0.027）相比，嗜酸细胞瘤的中位数μOCT明显更低。
我们证明，肾细胞癌的μOCT明显高于嗜酸细胞瘤，ROC 分析显示其具有良好的分化潜力。这表明经皮针基光相干断层扫描在帮助区分肾脏肿块方面具有潜力，因此需要进一步研究。
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