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Magnetic resonance imaging (MRI) helps differentiate renal cell carcinoma with sarcomatoid differentiation from renal cell carcinoma without sarcomatoid differentiation

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

Abstract

Purpose

The aim of the present study is to identify predictive imaging findings and construct a diagnostic model for differentiating renal cell carcinoma (RCC) with and without sarcomatoid dedifferentiation (sRCC and non-sRCC).

Methods

This study is a single-center retrospective study. All patients had magnetic resonance imaging (MRI) with gradient-echo T1-weighted images, single-shot T2-weighted images (T2WI), and enhanced nephrographic phase images. Forty pathologically confirmed sRCCs and 80 non-sRCCs were included in this study. Control cases were selected by matching the tumor diameter and the year of MRI. Two radiologists independently evaluated the following findings: growth pattern, presence of low-intensity area on T2WI in the tumor (T2LIA), presence of non-enhancing area, local tumor stage, and presence of regional lymphadenopathy. Two radiologists measured the diameter of the tumor, T2LIA, and the non-enhancing area. Multivariable logistic regression analysis was used to identify independent predictive factors for differentiating sRCC from non-sRCC. Selected variables were entered in the logistic regression model, and the area under the curve (AUC) was calculated for each reader with 95% confidence intervals (CIs).

Results

Larger T2LIA-to-tumor diameter ratio, regional lymphadenopathy, and local tumor stage 4 were associated with sRCC, and selected for the subsequent construction of a logistic regression model. With this model, the AUCs were 0.76 (95% CI, 0.66–0.85) and 0.70 (95% CI, 0.59–0.81) for prediction of sRCC.

Conclusion

In conclusion, larger T2LIA-to-tumor diameter ratio, regional lymphadenopathy, and local tumor stage 4 are predictive findings of sRCC. As a result, the model constructed using these findings demonstrated a moderate degree of diagnostic accuracy.

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Funding

This study was not funded from any grants or sources.

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Authors and Affiliations

  1. Radiolonet Tokai, 86-2, 3-chome, Asaoka-cho, Chikusa-ku, Nagoya, Aichi, 464-0811, Japan

    Mitsuru Takeuchi

  2. Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA

    Adam T. Froemming, Prabin Thapa, Rickey E. Carter, John C. Cheville, R. Houston Thompson & Naoki Takahashi

  3. Mayo Clinic, 13400 E. Shea Blvd., Scottsdale, AZ, 85259, USA

    Akira Kawashima

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  1. Mitsuru Takeuchi
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  2. Adam T. Froemming
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  6. John C. Cheville
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Correspondence to Naoki Takahashi.

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Takeuchi, M., Froemming, A.T., Kawashima, A. et al. Magnetic resonance imaging (MRI) helps differentiate renal cell carcinoma with sarcomatoid differentiation from renal cell carcinoma without sarcomatoid differentiation. Abdom Radiol 47, 2168–2177 (2022). https://doi.org/10.1007/s00261-022-03501-9

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  • DOI: https://doi.org/10.1007/s00261-022-03501-9

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