Tiwari Raj Vikesh, Ho Chia Ming, Huang Hong Hong, Ho Henry Sun Sien, Sim Allen Soon Phang
Department of Urology, Singapore General Hospital, Singapore.
Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
Int J Urol. 2018 May;25(5):436-441. doi: 10.1111/iju.13531. Epub 2018 Feb 8.
To determine the complexity of renal masses by using an objective novel imaging parameter (intraparenchymal tumor volume) based on computed tomography scans, to correlate this parameter to perioperative outcomes and to the RENAL nephrometry score.
After institutional review board approval, 87 patients who underwent partial nephrectomy between 2012 and 2016 at Singapore General Hospital, Singapore, were retrospectively analyzed. Preoperative computed tomography intravenous pyelogram scans were reviewed by a single senior radiologist who calculated the intraparenchymal tumor volume. Once the intraparenchymal tumor volume scores were obtained, they were compared with perioperative renal and surgical outcomes, and nephrometry scores. Furthermore, intraparenchymal tumor volume was subdivided into two categories, low and high intraparenchymal tumor volume, both using the 89th percentile.
The mean patient age was 60 years, and the mean tumor size was 2.9 cm. The mean nephrometry score was 7.8, and the mean intraparenchymal tumor volume score was 12.7 cm³. The cut-off for high intraparenchymal tumor volume was >27.26 cm³. As a continuous variable, intraparenchymal tumor volume showed a significant relationship with the percentage of creatinine change (P = 0.009) and nephrometry scores (P < 0.001). As a categorical variable, high intraparenchymal tumor volume showed significance when compared with absolute creatinine change (P = 0.018), percentage of creatinine change (P = 0.004) and nephrometry score (P < 0.001).
Intraparenchymal tumor volume represents a novel objective tool based on computed tomography imaging to determine the complexity of a renal mass. This tool correlates with renal functional outcomes of partial nephrectomy, and it also shows good correlation with RENAL nephrometry score.
基于计算机断层扫描，使用一种客观的新成像参数（实质内肿瘤体积）来确定肾肿物的复杂性，将该参数与围手术期结局以及RENAL肾计量评分相关联。
经机构审查委员会批准，对2012年至2016年期间在新加坡新加坡总医院接受部分肾切除术的87例患者进行回顾性分析。由一名资深放射科医生对术前计算机断层扫描静脉肾盂造影进行评估，计算实质内肿瘤体积。获得实质内肿瘤体积评分后，将其与围手术期肾脏及手术结局以及肾计量评分进行比较。此外，实质内肿瘤体积被分为两类，即低实质内肿瘤体积和高实质内肿瘤体积，均采用第89百分位数进行划分。
患者平均年龄为60岁，平均肿瘤大小为2.9 cm。平均肾计量评分为7.8，平均实质内肿瘤体积评分为12.7 cm³。高实质内肿瘤体积的临界值>27.26 cm³。作为连续变量，实质内肿瘤体积与肌酐变化百分比（P = 0.009）和肾计量评分（P < 0.001）显示出显著相关性。作为分类变量，高实质内肿瘤体积与肌酐绝对变化（P = 0.018）、肌酐变化百分比（P = 0.004）和肾计量评分（P < 0.001）相比具有显著性。
实质内肿瘤体积代表了一种基于计算机断层扫描成像的新型客观工具，用于确定肾肿物的复杂性。该工具与部分肾切除术的肾功能结局相关，并且与RENAL肾计量评分也显示出良好的相关性。
