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Diagnostic performance of diffusion-weighted magnetic resonance imaging in differentiating human renal lesions (benignity or malignancy): a meta-analysis

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Abstract

Purpose

This study aims to quantitatively evaluate the potential of diffusion-weighted magnetic resonance imaging (DW-MRI) for differentiating malignant and benign human renal lesions.

Materials and methods

A systematic literature was performed to identify previous research related to the diagnostic performance of DW-MRI for determining whether human renal lesions were benign or malignant. ADC values were extracted from normal renal tissue and different lesion types. Data were extracted to assess the diagnostic performance of DW-MRI for differentiating malignant and benign human renal lesions, as well as running threshold effect and heterogeneity.

Results

Nine publications with 11 subsets were eligible for data extraction and diagnostic performance calculation. A total of 988 apparent diffusion coefficient (ADC) measurements were included. The differences in ADC values between benign lesions (2.47 ± 0.81 × 10−3 mm2/s) and malignant lesions (1.81 ± 0.41 × 10−3 mm2/s) were statistically significant (P < 0.001). The diagnostic odds ratio, the overall positive, negative likelihood ratios, pooled weighted sensitivity and specificity with 95% CI were 20.05 (95% CI 12.56–32.02), 3.32 (95% CI 2.13–5.18), 0.20 (95% CI 0.15–0.27), 88% (95% CI 0.84–0.91) and 72% (95% CI 0.67–0.76), respectively. The area under the curve of the summary receiver operating characteristic was 0.90.

Conclusions

This meta-analysis indicated that DW-MRI had a relatively good diagnostic accuracy in differentiating malignant and benign human renal lesions. We preliminarily recommend that DW-MRI is performed with a maximum b value ranging from 800 to 1000 s/mm2 at 3.0 T for imaging protocol, and that DW-MRI should be used with caution when the study population includes children.

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Acknowledgements

We would like to thank Moira R. Hitchens (Department of Radiology, University of Pittsburgh) for revising our manuscript. This work was supported by Sichuan Provincial Science and Technology plan Grants 2011SZ0160.

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Authors and Affiliations

  1. Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China

    Hanmei Zhang, Rongbo Liu, Xijiao Liu, Zixing Huang, Fang Yuan & Bin Song

  2. Department of Neurosurgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China

    Qi Gan

  3. Department of Radiology, The Second Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, No. 15, Section 4 Renmin South Road, Chengdu, 610041, Sichuan, China

    Yinghua Wu & Min Kuang

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  1. Hanmei Zhang
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Correspondence to Bin Song.

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Conflict of Interest

Hanmei Zhang, Qi Gan, Yinghua Wu, Rongbo Liu, Xijiao Liu, Zixing Huang, Fang Yuan, Min Kuang, Bin Song declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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All analyses are based on previous published studies; thus, no informed consent is required.

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Zhang, H., Gan, Q., Wu, Y. et al. Diagnostic performance of diffusion-weighted magnetic resonance imaging in differentiating human renal lesions (benignity or malignancy): a meta-analysis. Abdom Radiol 41, 1997–2010 (2016). https://doi.org/10.1007/s00261-016-0790-z

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