Abstract
Preoperative renal tumor subtype differentiation is important for radiology and urology in clinical practice. Pharmacokinetic data (Ktrans & Ve, etc.) derived from dynamic contrast-enhanced MRI (DCE-MRI) have been used to investigate tumor vessel permeability. In this prospective study on DCE-MRI pharmacokinetic studies, we enrolled patients with five common renal tumor subtypes: clear cell renal cell carcinoma (ccRCC; n = 65), papillary renal cell carcinoma (pRCC; n = 12), chromophobic renal cell carcinoma (cRCC; n = 9), uroepithelial carcinoma (UEC; n = 14), and fat-poor angiomyolipoma (fpAML; n = 10). The results show that Ktrans of ccRCC, pRCC, cRCC, UEC and fpAML (0.459 ± 0.190 min−1, 0.206 ± 0.127 min−1, 0.311 ± 0.111 min−1, 0.235 ± 0.116 min−1, 0.511 ± 0.159 min−1, respectively) were different, but Ve was not. Ktrans could distinguish ccRCC from non-ccRCC (pRCC & cRCC) with a sensitivity of 76.9% and a specificity of 71.4%, respectively, as well as to differentiate fpAML from non-ccRCC with a sensitivity of 100% and a specificity of 76.2%, respectively. Our findings suggest that DCE-MRI pharmacokinetics are promising for differential diagnosis of renal tumors, especially for RCC subtype characterization and differentiation between fpAML and non-ccRCC, which may facilitate the treatment of renal tumors.
Highlights
Subtype characterization and differentiation between fat-poor renal angiomyolipoma (fpAML) and non-clear cell renal cell carcinoma (RCC) (ccRCC), which may facilitate the treatment of renal tumors
In this study, we used DCE-magnetic resonance imaging (MRI) pharmacokinetics to characterize renal masses among five renal tumor subtypes to determine if kinetic measurements could be used as an alternative diagnostic tool for the differential diagnosis of renal tumors
FpAML had the greatest Ktrans followed by ccRCC, chromophobic RCC (cRCC), UEC, and papillary RCC (pRCC)
Summary
Subtype characterization and differentiation between fpAML and non-ccRCC, which may facilitate the treatment of renal tumors. When combined with unenhanced images, DCE-MRI can be used to characterize cystic degeneration or necrosis within lesions, facilitating accurate tumor diagnosis and the documentation of therapeutic outcomes. DCE-MRI can discriminate between benign and malignant renal lesions[1, 14] and RCC subtypes[15, 16]. A DCE-MRI pharmacokinetic model can reflect tumor perfusion, vascular volume, and angiogenesis. It allows the quantification of the volume transfer constant from www.nature.com/scientificreports/. Plasma to the EES (Ktrans), the efflux rate constant from EES back to plasma (Kep), the ratio of the EES volume to tissue volume (Ve), and the ratio of blood plasma volume to tissue volume (Vp)
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