Routinely performed multiparametric magnetic resonance imaging helps to differentiate common subtypes of renal tumours
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To retrospectively evaluate the ability of multiparametric magnetic resonance (MR) imaging to differentiate renal tumours.
MR images from 100 consecutive pathologically proven solid renal tumours without macroscopic fat [57 clear cell, 16 papillary and 7 chromophobe renal cell carcinomas (RCCs), 16 oncocytomas and 4 minimal fat angiomyolipomas (AMLs)] between 2009 and 2012 were evaluated. Two radiologists blinded to pathology results independently reviewed double-echo chemical shift, dynamic contrast-enhanced T1- and T2-weighted images and apparent diffusion coefficient (ADC) maps. Signal intensity index (SII), tumour-to-spleen SI ratio (TSR), ADC ratio, wash-in (WiI) and wash-out indices (WoI) between different phases were calculated.
There were significant differences between papillary RCCs and other renal tumours for arterial WiI (P < 0.001), initial WoI (P = 0.006) and ADC ratio (P < 0.001); between chromophobe RCCs and oncocytomas for TSR (P = 0.02), parenchymal WiI (P = 0.03), late WiI (P = 0.02), initial WoI (P = 0.03) and late WoI (P = 0.04); and between clear cell RCCs and oncocytomas for SII (P = 0.01) and parenchymal WiI (P = 0.01). Papillary RCCs were distinguished from other tumours (sensitivity 37.5 %, specificity 100 %) and oncocytomas from chromophobe RCCs (sensitivity 25 %, specificity 100 %) and clear cell RCCs (sensitivity 100 %, specificity 94.2 %).
MR imaging provides criteria able to accurately distinguish papillary RCCs from other tumours and oncocytomas from chromophobe and clear cell RCCs.
• Multiparametric MR parameters accurately distinguish papillary RCCs with high specificity (100 %).
• Oncocytomas can be distinguished from chromophobe RCCs with high specificity (100 %).
• Oncocytomas can be distinguished from clear cell RCCs with high specificity (94.2 %).
• In oncocytomatosis, imaging follow-up with such parameters analysis could be promoted.
KeywordsRenal neoplasms Magnetic resonance imaging Renal cell carcinomas Oncocytomas Diffusion-weighted imaging
Apparent diffusion coefficient
Multiparametric magnetic resonance imaging
Renal cell carcinoma
Receiver operating characteristic
Region of interest
Signal intensity index
Signal intensity ratio
The authors thank Pippa McKelvie-Sebileau for medical editorial services.
The scientific guarantor of this publication is Professor Nicolas Grenier. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.