Abstract
BackgroundMRI provides several distinct quantitative parameters that may better differentiate renal cell carcinoma (RCC) subtypes. The purpose of the study is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC), chemical shift signal intensity index (SII), and contrast enhancement in differentiation between different subtypes of renal cell carcinoma.ResultsThere were 63 RCC as regard surgical histopathological analysis: 43 clear cell (ccRCC), 12 papillary (pRCC), and 8 chromophobe (cbRCC). The mean ADC ratio for ccRCC (0.75 ± 0.13) was significantly higher than that of pRCC (0.46 ± 0.12, P < 0.001) and cbRCC (0.41 ± 0.15, P < 0.001). The mean ADC value for ccRCC (1.56 ± 0.27 × 10−3 mm2/s) was significantly higher than that of pRCC (0.96 ± 0.25 × 10−3 mm2/s, P < 0.001) and cbRCC (0.89 ± 0.29 × 10−3 mm2/s, P < 0.001). The mean SII of pRCC (1.49 ± 0.04) was significantly higher than that of ccRCC (0.93 ± 0.01, P < 0.001) and cbRCC (1.01 ± 0.16, P < 0.001). The ccRCC absolute corticomedullary enhancement (196.7 ± 81.6) was significantly greater than that of cbRCC (177.8 ± 77.7, P < 0.001) and pRCC (164.3 ± 84.6, P < 0.001).ConclusionOur study demonstrated that multiparametric MRI is able to afford some quantitative features such as ADC ratio, SII, and absolute corticomedullary enhancement which can be used to accurately distinguish different subtypes of renal cell carcinoma.
Highlights
MRI provides several distinct quantitative parameters that may better differentiate renal cell carcinoma (RCC) subtypes
The mean apparent diffusion coefficient (ADC) ratio for ccRCC (0.75 ± 0.13) was significantly higher than that of pRCC (0.46 ± 0.12, P < 0.001) and cbRCC (0.41 ± 0.15, P < 0.001). Both ADC ratio and ADC value demonstrated no significant difference between pRCC and cbRCC with P values were 0.997 and 0.56
There are few published studies addressing the quantitative role of multiparametric MRI in the characterization of subtypes of renal cell carcinoma with no solid results till most of these studies were conducted upon 1.5 tesla MRI machines, our clinical research was unique as it was done at 3 tesla MRI machine, all our cases underwent surgical resection o the mass with histopathological correlation
Summary
MRI provides several distinct quantitative parameters that may better differentiate renal cell carcinoma (RCC) subtypes. The purpose of the study is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC), chemical shift signal intensity index (SII), and contrast enhancement in differentiation between different subtypes of renal cell carcinoma. Many authors have reported the promising value of imaging in non-invasive characterization of different subtypes of RCC [1]. The evaluation of the renal tumor subtypes utilizing some parameters of MRI could be beneficial for the protocol of management [2]. Clear cell RCC is the most common subtype of RCC, accounting for 65–80% of cases. Clear cell carcinomas are associated with a less favorable outcome than both papillary and chromophobe RCC subtypes, with a 5-year survival rate of 44–69% [3]
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