Published online Jul 28, 2015. doi: 10.4329/wjr.v7.i7.170
Peer-review started: December 2, 2014
First decision: February 7, 2015
Revised: March 30, 2015
Accepted: June 4, 2015
Article in press: June 8, 2015
Published online: July 28, 2015
Various imaging modalities are available for the diagnosis, staging and response evaluation of patients with renal cell carcinoma (RCC). While contrast enhanced computed tomography (CT) is used as the standard of imaging for size, morphological evaluation and response assessment in RCC, a new functional imaging technique like perfusion CT (pCT), goes down to the molecular level and provides new perspectives in imaging of RCC. pCT depicts regional tumor perfusion and vascular permeability which are indirect parameters of tumor angiogenesis and thereby provides vital information regarding tumor microenvironment. Also response evaluation using pCT may predate the size criteria used in Response Evaluation Criteria in Solid Tumors, as changes in the perfusion occurs earlier following tissue kinase inhibitors before any actual change in size. This may potentially help in predicting prognosis, better selection of therapy and more accurate and better response evaluation in patients with RCC. This article describes the techniques and role of pCT in staging and response assessment in patients with RCCs.
Core tip: Perfusion computed tomography is a functional imaging technique. It can be used to predict the histologic grade and early as well as more accurate response evaluation in renal cell carcinoma (RCC). This has the potential to help in better selection of therapy and improve prognosis in RCC.