Utilizing CT and MRI in Assessing Peritumoral Neovascularization in Renal Cell Carcinoma: A Comprehensive Analysis of Histological Subtypes and Tumor Characteristics by Imaging.

OBJECTIVE

There are variations in prognosis and therapeutic approach for renal cell carcinoma among different histological subtypes. This study aims to determine the relationship between radiologically detected peritumoral neovascularization and the histological subtypes of Renal Cell Carcinoma (RCC) and to assess whether extratumoral neovascularization characteristics detected via imaging can contribute to distinguishing these subtypes alongside tumor size and T-stage.

MATERIALS AND METHODS

104 renal tumors from 104 cases consisting of 31 females (29.8%) and 73 males (70.2%) who underwent abdominal CT or MRI and received a histopathological renal cell carcinoma diagnosis were included. Out of 104 cases, 45 (43.27%) cases had a preoperative CT, 52 (50%) cases had a preoperative MRI, and 7 (6.73%) cases had both preoperative CT and MR images. The cases were categorized according to the histopathologic subtypes. The presence of the radiologically visible peritumoral vascularity and its diameter was noted in order to compare with the histopathological subtypes and other morphologic or histopathological findings, including size, presence of cystic component, T score, and Fuhrman grade of the tumor.

RESULTS

104 unilateral renal tumors (median size 5 cm; range 2-26 cm) were included in this study, of which 71 (68.3%) were clear cell, 20 (9.2%) were papillary and 13 (12.5%) were chromophobe renal cell carcinomas. Although the presence of peritumoral neovascularization was observed to a lesser degree in papillary carcinomas than clear cell and chromophobe carcinomas, there was no statistically significant difference among histological subtypes and between clear cell and non-clear cell carcinomas according to the frequency of peritumoral neovascularization (p = 0.16 and p = 0.084). The presence of peritumoral neovascularization was significantly associated with tumor size for all tumors and within histological subtypes (p < 0.0001). As the diameter of the tumor increased, the presence of peritumoral neovascularization increased. T stage of tumors was significantly associated with both the presence of peritumoral neovascularization and the largest peritumoral vessel diameter (p < 0.01 and p = 0.002).

CONCLUSION

No statistically significant association between the histological subtype of tumors and the frequency of peritumoral neovascularization was found in this study. The frequency of peritumoral neovascularization increased with the size and T stage of the tumor. Additionally, the largest peritumoral vessel diameter increased with the T stage of the tumor. There was no statistically significant relationship between peritumoral vascularity and Fuhrman grade.