Differentiation of clear cell renal cell carcinoma from other renal cortical tumors by use of a quantitative multiparametric MRI approach Journal Article


Authors: Hotker, A. M.; Mazaheri, Y.; Wibmer, A.; Karlo, C. A.; Zheng, J.; Moskowitz, C. S.; Tickoo, S. K.; Russo, P.; Hricak, H.; Akin, O.
Article Title: Differentiation of clear cell renal cell carcinoma from other renal cortical tumors by use of a quantitative multiparametric MRI approach
Abstract: OBJECTIVE. The purpose of this study was to develop a quantitative multiparametric MRI approach to differentiating clear cell renal cell carcinoma (RCC) from other renal cortical tumors. MATERIALS AND METHODS. This retrospective study included 119 patients with 124 histopathologically confirmed renal cortical tumors who underwent preoperative MRI including DWI, contrast-enhanced, and chemical-shift sequences before nephrectomy. Two radiologists independently assessed each tumor volumetrically, and apparent diffusion coefficient values, parameters from multiphasic contrast-enhanced MRI (peak enhancement, upslope, downslope, AUC), and chemical-shift indexes were calculated. Univariate and multivariable logistic regression analyses were performed to identify parameters associated with clear cell RCC. RESULTS. Interreader agreement was excellent (intraclass correlation coefficient, 0.815- 0.994). The parameters apparent diffusion coefficient (reader 1 AUC, 0.804; reader 2, 0.807), peak enhancement (reader 1 AUC, 0.629; reader 2, 0.606), and downslope (reader 1 AUC, 0.575; reader 2, 0.561) were significantly associated with discriminating clear cell RCC from other renal cortical tumors. The combination of all three parameters further increased diagnostic accuracy (reader 1 AUC, 0.889; reader 2, 0.907; both p ≥ 0.001), yielding sensitivities of 0.897 for reader 1 and 0.897 for reader 2, and specificities of 0.762 for reader 1 and 0.738 for reader 2 in the identification of clear cell RCC. With maximized sensitivity, specificities of 0.429 and 0.262 were reached for readers 1 and 2, respectively. CONCLUSION. A quantitative multiparametric approach statistically significantly improves diagnostic performance in differentiating clear cell RCC from other renal cortical tumors. © 2017 American Roentgen Ray Society.
Keywords: neoplasms; diffusion; diagnostic imaging; renal cell carcinoma; kidney; mri; dwi
Journal Title: American Journal of Roentgenology
Volume: 208
Issue: 3
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2017-03-01
Start Page: W85
End Page: W91
Language: English
DOI: 10.2214/ajr.16.16652
PROVIDER: scopus
PUBMED: 28095036
PMCID: PMC5441564
DOI/URL:
Notes: Conference Paper -- Export Date: 3 April 2017 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Junting Zheng
    133 Zheng
  2. Paul Russo
    457 Russo
  3. Satish K Tickoo
    370 Tickoo
  4. Chaya S. Moskowitz
    173 Moskowitz
  5. Hedvig Hricak
    333 Hricak
  6. Oguz Akin
    179 Akin
  7. Christoph Alexander Karlo
    17 Karlo
  8. Andreas Markus Hoetker
    21 Hoetker
  9. Andreas Georg Wibmer
    18 Wibmer