Use of DWI in the differentiation of renal cortical tumors Journal Article


Authors: Hotker, A. M.; Mazaheri, Y.; Wibmer, A.; Zheng, J.; Moskowitz, C. S.; Tickoo, S. K.; Russo, P.; Hricak, H.; Akin, O.
Article Title: Use of DWI in the differentiation of renal cortical tumors
Abstract: Objective. The purpose of this study was to differentiate clear cell renal cell carcinoma (RCC) from other common renal cortical tumors by use of DWI. Materials and Methods. The study included 117 patients (mean age, 60 years) with 122 histopathologically confirmed renal cortical tumors who underwent 1.5-T MRI that included DWI before they underwent nephrectomy between 2006 and 2013. For each tumor, two radiologists independently evaluated apparent diffusion coefficient (ADC) values on the basis of a single ROI in a nonnecrotic area of the tumor and also by assessment of the whole tumor. The concordance correlation coefficient (CCC) was calculated to assess interreader agreement. The mean ADC values of clear cell RCC and every other tumor subtype were compared using an exact Wilcoxon rank sum test. RESULTS. Interreader agreement was excellent and higher in whole-tumor assessment (CCC, 0.982) than in single-ROI analysis (CCC, 0.756). For both readers, ADC values for clear cell RCC found on single-ROI assessment (2.19 and 2.08 × 10-3 mm2/s) and whole-tumor assessment (2.30 and 2.32 × 10-3 mm2/s) were statistically significantly higher than those for chromophobe, papillary, or unclassified RCC (p < 0.05) but were similar to those for oncocytoma found on single-ROI assessment (2.14 and 2.32 × 10-3 mm2/s) and whole-tumor assessment (2.38 and 2.24 × 10-3 mm2/s). ADC values were also higher for clear cell RCC than for angiomyolipoma, but the difference was statistically significant only in whole-tumor assessment (p < 0.03). Conclusion. ADC values were statistically significantly higher for clear cell RCC than for chromophobe, papillary, or unclassified RCC subtypes; however, differentiating clear cell RCC from oncocytoma by use of DWI remains especially challenging, because similar ADC values have been shown for these two tumor types. © American Roentgen Ray Society.
Keywords: adolescent; aged; major clinical study; nuclear magnetic resonance imaging; tumor volume; tumor differentiation; retrospective study; oncocytoma; renal cell carcinoma; kidney carcinoma; kidney neoplasms; nephrectomy; kidney tumor; angiomyolipoma; papillary carcinoma; diffusion weighted imaging; tumor classification; mri; kidney cortex; dwi; radiological procedures; very elderly; cancer; human; male; female; priority journal; article
Journal Title: American Journal of Roentgenology
Volume: 206
Issue: 1
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2016-01-01
Start Page: 100
End Page: 105
Language: English
DOI: 10.2214/ajr.14.13923
PROVIDER: scopus
PUBMED: 26700340
PMCID: PMC4826468
DOI/URL:
Notes: Article -- Export Date: 3 February 2016 -- Source: Scopus
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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. Andreas Markus Hoetker
    21 Hoetker
  8. Andreas Georg Wibmer
    18 Wibmer