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The role of diffusion-weighted MRI and contrast-enhanced MRI for differentiation between solid renal masses and renal cell carcinoma subtypes

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

Abstract

Purpose

To assess the value of diffusion-weighted magnetic resonance imaging (DW-MRI) and contrast-enhanced MRI (CE-MRI) for differentiation between benign and malignant solid renal masses, renal cell carcinoma (RCC) subtypes, oncocytomas, and lipid-poor angiomyolipomas (LP-AML).

Methods

Minimum or lowest ‘apparent diffusion coefficient’ (ADC1) and representative ADC values (ADC2) of 112 renal masses (n: 46 benign renal mass, n: 66 malignant renal mass) were measured on DW-MRI images (b 50, 400, 800 s/mm2). Signal intensity (SI) measurements were performed in normal renal parenchyma and most avid enhanced area of the renal masses at precontrast, corticomedullary, and nephrographic phases on CE-MRI. Contrast enhancement rate (CER) and contrast enhancement index (CEI) values of renal masses were compared between benign-malignant renal masses and RCC subtypes, oncocytomas, and LP-AMLs.

Results

There was no significant difference between ADC1, ADC2 values, and SI of benign and malignant renal masses (p = 0.721, p = 0.255, p = 0.872). Mean ADC1 and ADC2 values of clear cell RCCs were significantly higher than nonclear cell RCCs (p = 0.005 p = 0.002). Mean CER value of clear cell RCCs was significantly higher than nonclear cell RCCs in nephrographic phase (p = 0.003). Mean CEI values of clear cell RCCs were significantly higher than nonclear cell RCCs in the corticomedullary and nephrographic phase (p = 0.027 vs. 0.008). LP-AMLs were differentiated from other renal masses with wash-out phenomenon.

Conclusion

Combined usage of ADC, SI, CER, and CEI values may be useful for discrimination between RCC subtypes, oncocytomas, and lipid-poor AMLs.

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Authors and Affiliations

  1. Private Lokman Hekim Esnaf Hospital, Fethiye, Muğla, Turkey

    Aslı Serter

  2. Faculty of Medicine, Department of Radiology, Hacettepe University, Ankara, Turkey

    Mehmet Ruhi Onur

  3. Department of Pathology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Ganime Coban & Pelin Yildiz

  4. Uromer Urology Center, Atakoy Towers, Istanbul, Turkey

    Abdullah Armagan

  5. Bahcelievler Medical Park Hospital, Istanbul, Turkey

    Ercan Kocakoc

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  1. Aslı Serter
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  2. Mehmet Ruhi Onur
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Correspondence to Mehmet Ruhi Onur.

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Serter, A., Onur, M.R., Coban, G. et al. The role of diffusion-weighted MRI and contrast-enhanced MRI for differentiation between solid renal masses and renal cell carcinoma subtypes. Abdom Radiol 46, 1041–1052 (2021). https://doi.org/10.1007/s00261-020-02742-w

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  • DOI: https://doi.org/10.1007/s00261-020-02742-w

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