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Performance of clear cell likelihood scores in characterizing solid renal masses at multiparametric MRI: an external validation study

  • Kidneys, Ureters, Bladder, Retroperitoneum
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study is to evaluate the accuracy and interobserver agreement of ccLS in diagnosing clear cell renal cell carcinoma (ccRCC).

Methods

This retrospective single-center study evaluated consecutive patients with solid renal masses who underwent mpMRI followed by percutaneous biopsy and/or surgical excision between January 2010 and December 2020. Predominantly (> 75%) cystic masses, masses with macroscopic fat and infiltrative masses were excluded. Two abdominal radiologists independently scored each renal mass according to the proposed ccLS algorithm. The diagnostic performance of ccLS categories for ccRCC was calculated using logistic regression modeling. Diagnostic accuracy for predicting ccRCC was calculated using 2 × 2 contingency tables. Interobserver agreement for ccLS was evaluated with Cohen’s k statistic.

Results

A total of 79 patients (mean age, 63 years ± 12 [SD], 50 men) with 81 renal masses were evaluated. The mean size was 36 mm ± 28 (range 10–160). Of the renal masses included, 44% (36/81) were ccRCC. The area under the receiver operating characteristic curve was 0.87 (95% CI 0.79–0.95). Using ccLS ≥ 4 to diagnose ccRCC, the sensitivity, specificity, and positive predictive value were 93% (95% CI 79, 99), 63% (95% CI 48, 77), and 67% (95% CI 58, 75), respectively. The negative predictive value of ccLS ≤ 2 was 93% (95% CI 64, 99). The proportion of ccRCC by ccLS category 1 to 5 were 10%, 0%, 10%, 57%, and 84%, respectively. Interobserver agreement was moderate (k = 0.47).

Conclusion

In this study, clear cell likelihood score had moderate interobserver agreement and resulted in 96% negative predictive value in excluding ccRCC.

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Funding

The authors did not receive support from any organization for the submitted work. No funding was received to assist with the preparation of this manuscript. No funding was received for conducting this study. No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Radiology, McGill University Health Center, McGill University, 1650 Cedar Avenue, Montreal, QC, Canada

    Aisin Ibrahim

  2. Department of Radiology, Jewish General Hospital, McGill University, 3755 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1E2, Canada

    Vincent Pelsser, Youri Kaitoukov, Errol Camlioglu & Bardia Moosavi

  3. Department of Urology, Jewish General Hospital, McGill University, 3755 Chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1E2, Canada

    Maurice Anidjar

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  1. Aisin Ibrahim
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  2. Vincent Pelsser
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Correspondence to Bardia Moosavi.

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Ibrahim, A., Pelsser, V., Anidjar, M. et al. Performance of clear cell likelihood scores in characterizing solid renal masses at multiparametric MRI: an external validation study. Abdom Radiol 48, 1033–1043 (2023). https://doi.org/10.1007/s00261-023-03799-z

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  • DOI: https://doi.org/10.1007/s00261-023-03799-z

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