Radiogenomics of clear cell renal cell carcinoma: Associations between CT imaging features and mutations Journal Article


Authors: Karlo, C. A.; Di Paolo, P. L.; Chaim, J.; Hakimi, A. A.; Ostrovnaya, I.; Russo, P.; Hricak, H.; Motzer, R.; Hsieh, J. J.; Akin, O.
Article Title: Radiogenomics of clear cell renal cell carcinoma: Associations between CT imaging features and mutations
Abstract: Purpose: To investigate associations between computed tomographic (CT) features of clear cell renal cell carcinoma (RCC) and mutations in VHL, PBRM1, SETD2, KDM5C, or BAP1 genes. Materials and Methods: The institutional review board approved this retrospective, hypothesis-generating study of 233 patients with clear cell RCC and waived the informed consent requirement. The study was HIPAA compliant. Three radiologists independently reviewed pretreatment CT images of all clear cell RCCs without knowledge of their genomic profile. One radiologist measured largest diameter and enhancement parameters of each clear cell RCC. Associations between CT features and mutations in VHL, PBRM1, SETD2, KDM5C, and BAP1 genes were tested by using the Fisher exact test. Associations between mutations and size and enhancement were assessed by using the independent t test. Interreader agreement was calculated by using the Fleiss k. Results: Mutation frequencies among clear cell RCCs were as follows: VHL, 53.2% (124 of 233); PBRM1, 28.8% (67 of 233); SETD2, 7.3% (17 of 233); KDM5C, 6.9% (16 of 233); and BAP1, 6.0% (14 of 233). Mutations of VHL were significantly associated with well-defined tumor margins (P =.013), nodular tumor enhancement (P =.021), and gross appearance of intratumoral vascularity (P =.018). Mutations of KDM5C and BAP1 were significantly associated with evidence of renal vein invasion (P =.022 and.046, respectively). The genotype of solid clear cell RCC differed significantly from the genotype of multicystic clear cell RCC. While mutations of SETD2, KDM5C, and BAP1 were absent in multicystic clear cell RCC, mutations of VHL (P =.016) and PBRM1 (P =.017) were significantly more common among solid clear cell RCC. Interreader agreement for CT feature assessments ranged from substantial to excellent (k = 0.791-0.912). Conclusion: This preliminary radiogenomics analysis of clear cell RCC revealed associations between CT features and underlying mutations that warrant further investigation and validation. © RSNA, 2013.
Journal Title: Radiology
Volume: 270
Issue: 2
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2014-02-01
Start Page: 464
End Page: 471
Language: English
DOI: 10.1148/radiol.13130663
PROVIDER: scopus
PMCID: PMC4011179
PUBMED: 24029645
DOI/URL:
Notes: Cited By (since 1996):1 -- Export Date: 3 March 2014 -- CODEN: RADLA -- Source: Scopus
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MSK Authors
  1. Joshua Chaim
    40 Chaim
  2. Paul Russo
    581 Russo
  3. Robert Motzer
    1243 Motzer
  4. Hedvig Hricak
    419 Hricak
  5. James J Hsieh
    125 Hsieh
  6. Oguz Akin
    264 Akin
  7. Christoph Alexander Karlo
    18 Karlo
  8. Abraham Ari Hakimi
    324 Hakimi