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DOI: 10.1148/radiol.2501071712
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(Radiology 2009;250:137-144.)
© RSNA, 2009

Genitourinary Imaging

Distribution of Renal Tumor Growth Rates Determined by Using Serial Volumetric CT Measurements1

Jingbo Zhang, MD, Stella K. Kang, MD, Liang Wang, MD, Abdelkarim Touijer, MD, and Hedvig Hricak, MD, PhD

1 From the Departments of Radiology (J.Z., L.W., H.H.), Internal Medicine (S.K.K.), and Surgery (A.T.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10021. From the 2007 RSNA Annual Meeting. Received September 26, 2007; revision requested December 21; revision received March 17, 2008; accepted May 5; final version accepted July 18. Address correspondence to J.Z. (e-mail: zhangj12{at}mskcc.org).

Purpose: To retrospectively determine the distribution of growth rates across different sizes and subtypes of renal cortical tumors by assessing tumor volume and maximum tumor diameter at serial volumetric computed tomographic (CT) examinations.

Materials and Methods: The institutional review board approved this retrospective, HIPAA-compliant study. Fifty-three of 2304 patients (34 men, 19 women; mean age, 67 years ± 10 [standard deviation; range, 39–88 years) who underwent nephrectomy from 1989 to 2006 did not receive preoperative chemotherapy or radiation therapy and underwent at least two preoperative contrast material–enhanced CT examinations (at least 3 months apart) with identical section thickness that was no more than one-fifth of longitudinal tumor diameter. Tumor volume and maximum diameter were measured on CT scans. Reciprocal of doubling time (DT) (RDT) was calculated. Analysis of variance and Student t tests were performed.

Results: Thirty-two clear cell carcinomas, 10 papillary carcinomas, six chromophobe carcinomas, four oncocytomas, and one angiomyolipoma were analyzed. Median tumor size was 2.9 cm (range, 1–12 cm). Seven tumors did not increase in volume. DT ranged from –248 to 72 days (mean, 474 days; median, 811 days). Growth rate determined by using maximum diameter ranged from –10.8 to 33.2 mm/y (mean, 5.1 mm/y; median, 3.5 mm/y). Faster-growing tumors were more likely to be clear cell carcinomas, those of higher grade had higher growth rates. No significant correlation was found between RDT and tumor initial volume, subtype, or grade. Small renal tumors (≤3.5 cm) were similar to larger tumors in subtype and growth rate. Age at diagnosis correlated negatively with renal tumor growth rate (P = .03).

Conclusion: Growth rates in renal tumors of different sizes, subtypes, and grades represent a wide range and overlap substantially. Small renal tumors appear to be similar to larger ones in nature.

© RSNA, 2009




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B. K. Park and J. Zhang
Comments on "Distribution of Renal Tumor Growth Rates Determined by Using Serial Volumetric CT Measurements"
Radiology, July 1, 2009; 252(1): 314 - 315.
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