ArticleQuantitative imaging in medicine and surgery2022
Associations between tumor grade, contrast-enhanced ultrasound features, and microvascular density in patients with clear cell renal cell carcinoma: a retrospective study.
Article in Quantitative imaging in medicine and surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed.
- Preoperative identification of adverse pathology in clinically localized clear cell renal cell carcinoma: development and external validation of a contrast-enhanced ultrasound-based model.Abdominal radiology (New York) · 2026Article
- A contrast-enhanced ultrasound-based nomogram for preoperative prediction of pseudocapsule status in localized clear cell renal cell carcinoma: a retrospective study.Translational andrology and urology · 2026Article
- CD31-associated vascular phenotyping using Doppler ultrasound and dual-energy CT for recurrence risk stratification in papillary thyroid cancer.Cancer imaging : the official publication of the International Cancer Imaging Society · 2025Article
- High-frame-rate contrast-enhanced ultrasound to differentiate between clear cell renal cell carcinoma and angiomyolipoma.BMC cancer · 2024Article
- Nomogram combining pre-operative clinical characteristics and spectral CT parameters for predicting the WHO/ISUP pathological grading in clear cell renal cell carcinoma.Abdominal radiology (New York) · 2024Article
- Correlations between contrast-enhanced ultrasound and microvessel density in non-small cell lung cancer: A prospective study.Frontiers in oncology · 2023Article
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Abstract
Background: Clear cell renal cell carcinoma (ccRCC) comprises 70% of all renal cell carcinomas (RCCs). Currently, the most important prognostic factor for this type of carcinoma is the World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade. However, nonsurgical methods are rarely used to determine a tumor's WHO/ISUP grade, thus limiting the development of nonsurgical therapies. Due to variations in microvascular density (MVD) at different stages of tumor growth, contrast-enhanced ultrasound (CEUS) features may provide a noninvasive method for evaluating the WHO/ISUP grade of ccRCC. Methods: In this study, we analyzed confirmed cases of ccRCC using CEUS features. We also used CD34 and CD31 antibodies to determine MVD. The heterogeneity of CD34 and CD31 expressions were used to determine different degrees of angiogenesis. Results: When compared to WHO/ISUP grade I/II (G1/G2) tumors, grade III/IV (G3/G4) tumors had reduced peak intensity (PI) (P=0.006), time to peak (TTP) (P<0.001), and relative enhancement percentage index (∆PI%) (P<0.001). However, the frequency of incomplete pseudocapsule (P=0.049) and slow wash-in (P=0.001) was significantly higher in G3/G4 tumors. A cut-off value of ∆PI% <33.15% (P<0.001) allowed identification of G3/G4 tumors with an area under the curve (AUC) of 0.80 [95% confidence interval (CI): 0.70 to 0.91) and a sensitivity of 80%. The mean CD34 Conclusions: The features of CEUS are effective for differentiating G3/G4 tumors from G1/G2. There was a positive correlation detected between ∆PI% and MVD, and the density of undifferentiated vessels showed a significant difference between slow wash-in and fast wash-in cases. These findings indicate that CEUS can enable the sonographic visualization of tumor angiogenesis and thus be considered an acceptable method for the nonsurgical assessment of tumor microvascular distribution and grade.
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