Multiphasic contrast-enhanced MRI: Single-slice versus volumetric quantification of tumor enhancement for the assessment of renal clear-cell carcinoma fuhrman grade Journal Article

   

Authors:	Vargas, H. A.; Delaney, H. G.; Delappe, E. M.; Wang, Y.; Zheng, J.; Moskowitz, C. S.; Tan, Y.; Zhao, B.; Schwartz, L. H.; Hricak, H.; Russo, P.; Akin, O.
Article Title:	Multiphasic contrast-enhanced MRI: Single-slice versus volumetric quantification of tumor enhancement for the assessment of renal clear-cell carcinoma fuhrman grade
Abstract:	Purpose: To assess the association between clear-cell carcinoma pathology grade at nephrectomy and magnetic resonance imaging (MRI) tumor enhancement. Materials and Methods: The Institutional Review Board approved this retrospective study and waived the informed consent requirement. In all, 32 patients underwent multiphase contrast-enhanced MRI prior to nephrectomy. MRI tumor enhancement was measured using two approaches: 1) the most enhancing portion of the tumor on a single slice and 2) volumetric analysis of enhancement in the entire tumor. Associations between pathological grade, tumor size, and enhancement were evaluated using the Kruskal-Wallis test and generalized logistic regression models. Results: No significant association between pathology grade and enhancement was found when measurements were made on a single slice. When measured in the entire tumor, significant associations were found between higher pathology grades and lower mean, median, top 10%, top 25%, and top 50% tumor enhancement (P < 0.001-0.002). On multivariate analysis the association between grade and enhancement remained significant (P = 0.041-0.043), but tumor size did not make an additional contribution beyond tumor enhancement alone in differentiating between tumor grades. Conclusion: There is significant association between tumor grade and enhancement, but only when measured in the entire tumor and not on the most enhancing portion on a single slice. © 2012 Wiley Periodicals, Inc.
Keywords:	adult; clinical article; aged; middle aged; histopathology; nuclear magnetic resonance imaging; magnetic resonance imaging; cancer grading; sensitivity and specificity; reproducibility of results; disease association; image interpretation, computer-assisted; oncology; retrospective study; algorithms; histology; renal cell carcinoma; kidney carcinoma; kidney neoplasms; nephrectomy; partial nephrectomy; carcinoma, renal cell; image enhancement; tumor burden; contrast enhancement; imaging, three-dimensional; cancer size; contrast media; metastasis potential; clear cell carcinoma; gadolinium dtpa; diffusion weighted imaging; genitourinary; aggressiveness; neoplasm grading
Journal Title:	Journal of Magnetic Resonance Imaging
Volume:	37
Issue:	5
ISSN:	1053-1807
Publisher:	Wiley Blackwell
Date Published:	2013-05-01
Start Page:	1160
End Page:	1167
Language:	English
PROVIDER:	scopus
PUBMED:	23152173
DOI:	10.1002/jmri.23899
PMCID:	PMC3989993
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84876475370&partnerID=40&md5=c55ab9f4b548dff234094df5381a9090
Notes:	--- - "Export Date: 1 May 2013" - "CODEN: JMRIF" - ":doi 10.1002/jmri.23899" - "Source: Scopus"

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