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Abstract #3875

Dynamic Contrast Enhanced MRI Detection of a Central Defect in Clear Cell Renal Cell Carcinoma Correlates with a Tumor Scar and Lower Tumor Proliferation Rate

Yue Zhang 1 , Payal Kapur 2,3 , Qing Yuan 1 , Ananth Madhuranthakam 1,4 , Ingrid Carvo 5 , Sabina Signoretti 5 , Ivan Dimitrov 6 , Yin Xi 1 , Katherine Wicks 1 , Jeffrey Cadeddu 1,3 , Vitaly Margulis 3 , James Brugarolas 7,8 , and Ivan Pedrosa 1,4

1 Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States, 2 Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, United States, 3 Urology, University of Texas Southwestern Medical Center, Dallas, Texas, United States, 4 Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States, 5 Pathology, Brigham and Womens Hospital, Boston, Massachusetts, United States, 6 Philips Medical Systems, Cleveland, Ohio, United States, 7 Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States, 8 Developmental Biology, University of Texas Southwestern Medical Center, Dallas, Texas, United States

The purpose was to investigate if the central non-enhancing defect seen commonly on contrast-enhanced MRI in clear cell renal cell carcinoma (ccRCC) correlates with coagulation necrosis at histopathology in the same tumor, a known poor prognostic feature for these tumors. We found that non-enhancing defects in ccRCC represent tumor scars instead of coagulative necrosis. Ki-67 staining revealed significantly lower cell proliferation rate for RCC with scar than that for those without scar. We hypothesize that this scar is the result of rapid enlargement of the tumor leading to a central infarct and may be formed during a subsequent reparative phase.

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