Abstract
To investigate the value of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in differentiating clear-cell renal cell carcinoma (CCRCC) from low-fat renal angiomyolipomas (RAML), and to obtain the optimal b value. Fifty patients, including 30 cases of CCRCC and 20 cases of low-fat RAML, were retrospectively recruited to participate in this study. Before renal nephrectomy, all subjects underwent functional magnetic resonance imaging. For diffusion tensor imaging (DTI), a respiratory-triggered coronal echo planar imaging sequence was performed with three groups of different b values (0 and 400, 600, and 800). The ADC and FA of kidneys were analyzed and compared between different b values using analysis of variance. Receiver operation characteristic analysis was computed to assess the diagnostic performance of ADC and FA in differentiating low-fat RAML from CCRCC and to determine the optimal b values. With either CCRCC or low-fat RAML, the ADC values decreased with increased b values and significant differences were observed (F = 11.34, 23.15, P < 0.05), while the FA values were not significantly different (F = 0.28, 2.80, P > 0.05). The statistical differences in ADC, and the FA values for CCRCC and low-fat RAML were significantly different (P < 0.05). When the b value was 0.800 s/mm2, the cutoff FA value for differentiating CCRCC from low-fat RAML was 0.254 × 10.3 mm2/s, and had a sensitivity of 100 %, and a specificity of 73.3 %. MR-DTI can be used to differentiate CCRCC from low-fat RAML.
Highlights
Renal angiomyolipoma (RAML) is a benign neoplasm, which is formed by various tissues, including blood vessels, fat, and muscle
This study investigated the diagnostic efficacy of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values in differentiating between clear cell renal cell carcinomas (CCRCC) and low-fat RAML, and determined the optimal b values
The ADC values in the lowfat RAML group ranged from 1.51 to 1.80 × 10.3 mm2/s. Both the clearcell renal cell carcinoma (CCRCC) and low-fat RAML ADC values tended to decrease with increased b value, and significant differences among different b values were observed
Summary
Renal angiomyolipoma (RAML) is a benign neoplasm, which is formed by various tissues, including blood vessels, fat, and muscle. Identification of renal tumor type is essential to the choice of treatment. Diffusion weighted imaging (DWI) reflects water motion at the molecular level and provides useful information on parenchymal microstructure and function with the major advantages of not using ionizing radiation or potentially nephrotoxic contrast agents (Notohamiprodjo et al 2008; Palmucci et al 2011). Several reports have demonstrated the usefulness of DWI in renal tumor diagnosis (Wang et al 2010; Kim et al 2009; Cova et al 2004; Squillaci et al 2004a, b; Taouli et al 2009; Manenti et al 2008; Zhang et al 2008; Sandrasegaran et al 2010; Kilickesmez et al 2009)
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