TY - JOUR
T1 - Quantitative multiparametric mr analysis of small renal lesions
T2 - Correlation with surgical pathology
AU - Yano, Motoyo
AU - Fowler, Kathryn J.
AU - Srisuwan, Santip
AU - Salter, Amber
AU - Siegel, Cary L.
N1 - Publisher Copyright:
© Springer Science+Business Media, LLC, part of Springer Nature 2018.
PY - 2018/4/24
Y1 - 2018/4/24
N2 - Purpose: The purpose of the study is to evaluate the utility of apparent diffusion coefficient (ADC), chemical shift signal intensity index (SII), and contrast enhancement in distinguishing between benign lesions and renal cell carcinoma (RCC) and between subtypes of renal lesions. Methods: This retrospective study included 98 renal lesions (£ 3 cm) on MRI with correlative surgical pathology. Scanner field strength, lesion location, and size were recorded. Two readers blinded to surgical pathology independently measured ADC ratio (ADC lesion/ADC non-lesion kidney), SII, and absolute/relative enhancement in the corticomedullary and nephrographic phases of contrast. Results: There were 76 malignant and 22 benign lesions. 42 RCC were clear cell (ccRCC), 19 papillary (pRCC), 5 chromophobe (cbRCC). Benign lesions included both solid and cystic lesions. Interreader agreement for all variables was good-excellent (ICC 0.70-0.91). There was no difference in ADC or SII between benign and malignant lesions. There was greater absolute corticomedullary enhancement of benign versus malignant lesions (150.0 ± 111.5 vs. 81.1 ± 74.8, p = 0.0115), which did not persist when excluding pRCC. For lesion subtype differentiation,ADCratio for pRCCwas lower than benign lesions (0.74 ± 0.35 vs. 1.03 ± 0.46, p = 0.0246). ccRCC demonstrated greater SII than otherRCC(0.09 ± 0.22 vs. 0.001 ± 0.26, p = 0.0412). Oncocytomas and angiomyolipoma (AML) showed greater absolute corticomedullary enhancement than ccRCC and pRCC (145.6 ± 65.2 vs. 107.2 ± 85.3, p = 0.043 and 186.2 ± 93.9 vs. 37.6 ± 35.3, p = 0.0108), respectively. Conclusions: While corticomedullary-phase enhancement was a differentiating feature, quantitative metrics from diffusion and chemical shift imaging cannot reliably differentiate benign from malignant lesions. Quantitative assessment may be useful in differentiating some benign and malignant lesion subtypes.
AB - Purpose: The purpose of the study is to evaluate the utility of apparent diffusion coefficient (ADC), chemical shift signal intensity index (SII), and contrast enhancement in distinguishing between benign lesions and renal cell carcinoma (RCC) and between subtypes of renal lesions. Methods: This retrospective study included 98 renal lesions (£ 3 cm) on MRI with correlative surgical pathology. Scanner field strength, lesion location, and size were recorded. Two readers blinded to surgical pathology independently measured ADC ratio (ADC lesion/ADC non-lesion kidney), SII, and absolute/relative enhancement in the corticomedullary and nephrographic phases of contrast. Results: There were 76 malignant and 22 benign lesions. 42 RCC were clear cell (ccRCC), 19 papillary (pRCC), 5 chromophobe (cbRCC). Benign lesions included both solid and cystic lesions. Interreader agreement for all variables was good-excellent (ICC 0.70-0.91). There was no difference in ADC or SII between benign and malignant lesions. There was greater absolute corticomedullary enhancement of benign versus malignant lesions (150.0 ± 111.5 vs. 81.1 ± 74.8, p = 0.0115), which did not persist when excluding pRCC. For lesion subtype differentiation,ADCratio for pRCCwas lower than benign lesions (0.74 ± 0.35 vs. 1.03 ± 0.46, p = 0.0246). ccRCC demonstrated greater SII than otherRCC(0.09 ± 0.22 vs. 0.001 ± 0.26, p = 0.0412). Oncocytomas and angiomyolipoma (AML) showed greater absolute corticomedullary enhancement than ccRCC and pRCC (145.6 ± 65.2 vs. 107.2 ± 85.3, p = 0.043 and 186.2 ± 93.9 vs. 37.6 ± 35.3, p = 0.0108), respectively. Conclusions: While corticomedullary-phase enhancement was a differentiating feature, quantitative metrics from diffusion and chemical shift imaging cannot reliably differentiate benign from malignant lesions. Quantitative assessment may be useful in differentiating some benign and malignant lesion subtypes.
KW - Chemical shift
KW - Diffusion-weighted imaging
KW - Enhancement
KW - Magnetic resonance
KW - Malignancy
KW - Renal mass
UR - http://www.scopus.com/inward/record.url?scp=85045948923&partnerID=8YFLogxK
U2 - 10.1007/s00261-018-1612-2
DO - 10.1007/s00261-018-1612-2
M3 - Article
C2 - 29691619
AN - SCOPUS:85045948923
VL - 43
SP - 3390
EP - 3399
JO - Abdominal Radiology
JF - Abdominal Radiology
SN - 2366-004X
IS - 12
ER -