Abstract
Objective:
To avoid unnecessary surgical treatment of small renal masses (≤4 cm), a more accurate diagnostic method would be desirable since radiological differentiation between malignant and benign is difficult and nondiagnostic biopsies account from 9% to 37%. Optical coherence tomography (OCT) measures backscattered light versus depth, with an attenuation coefficient (μ t) that may vary among different histological types. We hypothesize that quantitative measurements of μ t using OCT can differentiate between normal renal parenchyma and renal cell carcinoma (RCC).
Materials and Methods:
Both normal and tumor renal tissues (RCC) were harvested after partial or radical nephrectomy. Analysis of μ t was based on difference of (1) μ t between normal and tumor tissue across all patients and (2) μ t between normal and tumor tissue within individual patients.
Results:
Tissue samples of 18 patients were measured, of which 4 were excluded (urothelial carcinoma, oncocytoma, and benign lesion without normal tissue available). Of the remaining 14 patients, 8 contributed with both normal and RCC tissue and 6 with only normal or RCC tissue. Independent observation showed a significant difference between the median μ t of normal renal tissue (4.95 mm−1) and the median μ t of RCC (8.86 mm−1). No statistically significant difference was found when comparing the difference in μ t between normal renal parenchyma and RCC within individual patients.
Conclusion:
There is a significant difference in μ t between normal and RCC tissue across all patients. These results overpower the lack of significant difference within individuals, encouraging further research and suggesting a possible role for OCT in the diagnostic work-up of renal masses.
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