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Multiparametric magnetic resonance imaging for the differentiation of low and high grade clear cell renal carcinoma

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Abstract

Purpose

To retrospectively evaluate the ability of magnetic resonance (MR) imaging to differentiate low from high Fuhrman grade renal cell carcinoma (RCC).

Materials and methods

MR images from 80 consecutive pathologically proven RCC (57 clear cell, 16 papillary and 7 chromophobe) were evaluated. Double-echo chemical shift, dynamic contrast-enhanced T1- and T2-weighted images and apparent diffusion coefficient (ADC) maps were reviewed independently. 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 and compared to pathological grade and size. The Fuhrman scoring system was used. Low grade (score ≤2) and high grade (score ≥3) tumours were compared using univariate and multivariate analyses.

Results

No associations between grade and imaging factors were found for papillary and chromophobe RCCs. For clear cell RCCs, there was a significant association between the grade and parenchymal WiI (WiI2) (P = 0.02) or ADCr (P = 0.03). A significant association between tumour grade and size (P = 0.01), WiI2 (P = 0.02) and ADCr (P = 0.05) remained in multivariate analysis.

Conclusions

Multiparametric MRI can be used to accurately differentiate low Fuhrman grade clear cell RCC from high grade. High Fuhrman grade (≥3) RCCs were larger, had lower parenchymal wash-in indices and lower ADC ratios than low grade.

Key Points

• Fuhrman grade of clear cell RCC can be differentiated with multiparametric MR imaging.

• Fuhrman grade significantly differed for size, parenchymal wash-in index and ADC ratio.

• No significant associations were found for papillary and chromophobe renal cell carcinoma.

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Abbreviations

ADC:

Apparent diffusion coefficient

au:

Arbitrary units

DCE:

Dynamic contrast-enhanced

Gd:

Gadolinium

GE:

Gradient echo

mpMRI:

Multiparametric magnetic resonance imaging

MR:

Magnetic resonance

RCC:

Renal cell carcinoma

ROI:

Region of interest

SII:

Signal intensity index

SIR:

Signal intensity ratio

TSR:

Tumour-to-spleen ratio

WiI:

Wash-in index

WoI:

Wash-out index

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Acknowledgements

The authors thank Pippa McKelvie-Sebileau for medical editorial services.

The scientific guarantor of this publication is Prof. 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.

Author information

Authors and Affiliations

  1. Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France

    F. Cornelis, E. Tricaud, A. S. Lasserre, F. Petitpierre, Y. Le Bras, M. Bouzgarrou & N. Grenier

  2. Department of Urology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France

    J. C. Bernhard

  3. Department of Pathology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France

    M. Yacoub

  4. Department of Oncology, Saint-André Hospital, rue Léon Burguet, 33076, Bordeaux, France

    A. Ravaud

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  1. F. Cornelis
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  2. E. Tricaud
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  10. N. Grenier
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Correspondence to F. Cornelis.

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Cornelis, F., Tricaud, E., Lasserre, A.S. et al. Multiparametric magnetic resonance imaging for the differentiation of low and high grade clear cell renal carcinoma. Eur Radiol 25, 24–31 (2015). https://doi.org/10.1007/s00330-014-3380-x

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  • DOI: https://doi.org/10.1007/s00330-014-3380-x

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