Operating-room technicians: their role and training.
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Education↗
Biomedical subjects
J C Presti
Publications and source records attributed to J C Presti.
MR imaging evaluation of renal cell carcinoma.
BACKGROUND: This study examines the minimally required imaging protocol needed for detection and staging of renal cell carcinoma (RCC). METHODS: In 81 patients (21 women, 60 men; mean age = 62 years) with 85 RCCs, T1-weighted (T1WI), contrast-enhanced T1-weighted (Gd-T1WI), T2-weighted (T2WI), and gradient recalled echo-fast low flip angle shot (GRE/FLASH) images were evaluated alone and in combination. Surgical-pathological findings were available in all patients and were considered the standard of reference. RESULTS: Tumor detection for lesions smaller than 3 cm was better on Gd-T1WI than on any other sequence, but only the comparison with noncontrast T1WI and GRE/FLASH was statistically significant (detection: T1WI = 33%, Gd-TIWI = 80%, T2WI = 60%, GRE = 47%). The respective accuracies of T1WI, Gd-T1WI, T2WI, and GRE/FLASH images were 81%, 78%, 71%, and 62% for evaluating local tumor extension; 90%, 88%, 89%, and 85% for lymphadenopathy; and 89%, 81%, 91%, and 95% for renal vein thrombus. The combination of T1WI and GRE sequences rendered the highest overall staging accuracy. CONCLUSION: For tumor detection, contrast-enhanced T1WI is necessary for lesions smaller than 3 cm. For tumor staging, although the addition of GRE results in significant improvement in the evaluation of venous thrombus, any combination of two sequences will result in similar accuracy, and the use of multiple sequences is not necessary.
Carcinoma, Renal Cell↗
Expression of the retinoblastoma gene product in renal tumors.
BACKGROUND: Alterations in the retinoblastoma (Rb) gene and its protein product have been detected in numerous solid tumor malignancies. Loss of Rb function is believed to contribute to neoplastic transformation or to the development of metastases. To define the role of Rb in renal cancer, we analyzed renal tumor specimens for molecular alterations in the Rb gene and for lack of Rb protein expression, and correlated the results to clinicopathological characteristics. MATERIALS AND METHODS: Thirteen renal cancer cell lines, 62 primary renal tumors, and 5 metastatic renal cancers were studied by Southern blot analysis for defects in the Rb gene, and by immunohistochemistry for Rb protein expression. Results were correlated with histopathological parameters and patient survival. RESULTS: Structural alterations in the Rb gene were not detects in any of the renal cancer cell line or primary renal tumors studied. A rearranged Rb gene was observed in 1/5 metastatic tumor specimens. Western blot analyses revealed a truncated Rb protein in one of 13 renal cancer cell lines; immunohistochemical analysis revealed Rb protein in all papillary and oncocytic tumors, and in 39/44 non-papillary tumors. Rb expression patterns did not correlate with pathological stage, histological grade or the development of metastatic disease. CONCLUSION: Molecular alterations of the Rb gene are infrequent (<2%) in renal cancers, and Rb protein is present in the majority of primary (92%) and metastatic (100%) renal tumors. Loss of Rb expression does not appear to significantly contribute to malignant transformation or progression of renal cancers.
Adenocarcinoma↗