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European Radiology

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01-12-2017 | Oncology

Diffusion-weighted imaging versus contrast-enhanced MR imaging for the differentiation of renal oncocytomas and chromophobe renal cell carcinomas

Authors: Yan Zhong, Haiyi Wang, Yanguang Shen, Aitao Guo, Jia Wang, Suhai Kang, Lu Ma, Jingjing Pan, Huiyi Ye

Published in: European Radiology | Issue 12/2017

Abstract

Objectives

To compare the performance of diffusion-weighted imaging (DWI) with that of contrast-enhanced MRI in differentiating renal oncocytomas from chromophobe renal cell carcinomas (RCCs).

Methods

We recruited 48 patients with histopathologically confirmed renal oncocytomas (n=16) and chromophobe RCCs (n=32). All patients underwent preoperative DWI and contrast-enhanced MRI. Apparent diffusion coefficient (ADC) and signal intensity were measured in each patient. ADC ratio and percentage of signal intensity change were calculated.

Results

Mean ADC values for renal oncoctytomas were significantly higher than those for chromophobe RCCs (1.59±0.21 vs. 1.09±0.29× 10⁻³ mm²/s, p < 0.001). Area under the ROC curve, sensitivity and specificity were 0.931, 87.5% and 84.4%, respectively, for ADC measurement of DW imaging; 0.825, 87.5% and 75%, respectively, for enhancement ratio (p > 0.05). Adding ADC values to the enhancement ratios in the ROC, analysis to differentiate renal oncocytoma from chromophobe RCCs increased specificity from 75 to 87.5% at 87.5% sensitivity without significantly increasing the AUC (0.930).

Conclusions

Both DWI and contrast-enhanced MRI may assist in differentiating renal oncocytomas from chromophobe RCCs, with DWI showing higher diagnostic value. The combination of the two parameters could potentially provide better performance in distinguishing these two tumours.

Key Points

• ADC values can assist in differentiating renal oncocytomas from chromophobe RCCs.

• DW imaging possesses better specificity than does contrast-enhanced MR imaging.

• Combining the two parameters provides higher specificity regarding the differential diagnosis.

Amin MB, Crotty TB, Tickoo SK et al (1997) Renal oncocytoma: a reappraisal of morphologic features with clinicopathologic findings in 80 cases. Am J Surg Pathol 21:1–12CrossRefPubMed

Ljungberg B, Bensalah K, Canfield S et al (2015) EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol 67:913–924CrossRefPubMed

Lopez-Beltran A, Scarpelli M, Montironi R et al (2006) 2004 WHO classification of the renal tumors of the adults. Eur Urol 49:798–805CrossRefPubMed

Oxley JD, Sullivan J, Mitchelmore A et al (2007) Metastatic renal oncocytoma. J Clin Pathol 60:720–722CrossRefPubMedPubMedCentral

Tickoo SK, Amin MB (1998) Discriminant nuclear features of renal oncocytoma and chromophobe renal cell carcinoma: analysis of their potential utility in the differential diagnosis. Am J Clin Pathol 110:782–787CrossRefPubMed

Ishigami K, Jones AR, Dahmoush L et al (2015) Imaging spectrum of renal oncocytomas: a pictorial review with pathologic correlation. Insights Imaging 6:53–64CrossRefPubMed

Rosenkrantz AB, Hindman N, Fitzgerald EF et al (2010) MRI features of renal oncocytoma and chromophobe renal cell carcinoma. AJR Am J of Roentgenol 195:W421–W427CrossRef

Schieda N, Al-Subhi M, Flood TA et al (2014) Diagnostic accuracy of segmental enhancement inversion for the diagnosis of renal oncocytoma using biphasic computed tomography (CT) and multiphase contrast-enhanced magnetic resonance imaging (MRI). Eur Radiol 24:2787–2794CrossRefPubMed

Cornelis F, Tricaud E, Lasserre AS et al (2014) Routinely performed multiparametric magnetic resonance imaging helps to differentiate common subtypes of renal tumours. Eurn Radiol 24:1068–1080CrossRef

10.

Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635CrossRefPubMed

11.

Zhang J, Tehrani YM, Wang L et al (2008) Renal masses: characterization with diffusion-weighted MR imaging--a preliminary experience. Radiology 247:458–464CrossRefPubMed

12.

Taouli B, Thakur RK, Mannelli L et al (2009) Renal lesions: characterization with diffusion-weighted imaging versus contrast-enhanced MR imaging. Radiology 251:398–407CrossRefPubMed

13.

Kim S, Jain M, Harris AB et al (2009) T1 hyperintense renal lesions: characterization with diffusion-weighted MR imaging versus contrast-enhanced MR imaging. Radiology 251:796–807CrossRefPubMed

14.

Sevcenco S, Heinz-Peer G, Ponhold L et al (2014) Utility and limitations of 3-Tesla diffusion-weighted magnetic resonance imaging for differentiation of renal tumors. Eur J Radiol 83:909–913CrossRefPubMed

15.

Padhani AR, Liu G, Koh DM et al (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125CrossRefPubMedPubMedCentral

16.

Lassel EA, Rao R, Schwenke C et al (2014) Diffusion-weighted imaging of focal renal lesions: a meta-analysis. Eur Radiol 24:241–249CrossRefPubMed

17.

Razek AA, Farouk A, Mousa A et al (2011) Role of diffusion-weighted magnetic resonance imaging in characterization of renal tumors. J Comput Assist Tomogr 35:332–336CrossRefPubMed

18.

Goya C, Hamidi C, Bozkurt Y et al (2015) The role of apparent diffusion coefficient quantification in differentiating benign and malignant renal masses by 3 Tesla magnetic resonance imaging. Balkan Med J 32:273–278CrossRefPubMedPubMedCentral

19.

Lei Y, Wang H, Li HF et al (2015) Diagnostic significance of diffusion weighted MRI in renal cancer. Biomed Res Int 2015:172165PubMedPubMedCentral

20.

Sandrasegaran K, Sundaram CP, Ramaswamy R et al (2010) Usefulness of diffusion-weighted imaging in the evaluation of renal masses. AJR Am J Roentgenol 194:438–445

21.

Mirka H, Korcakova E, Kastner J et al (2015) Diffusion-weighted imaging using 3.0 T MRI as a possible biomarker of renal tumors. Anticancer Res 35:2351–2357PubMed

22.

Hotker AM, Mazaheri Y, Wibmer A et al (2016) Use of DWI in the differentiation of renal cortical tumors. AJR Am J Roentgenol 206:100–105CrossRefPubMedPubMedCentral

23.

Le Bihan D (1988) Intravoxel incoherent motion imaging using steady-state free precession. Magn Reson Med 7:346–351CrossRefPubMed

24.

Pedrosa I, Sun MR, Spencer M et al (2008) MR imaging of renal masses: correlation with findings at surgery and pathologic analysis. Radiographics 28:985–1003CrossRefPubMed

25.

Goyal A, Sharma R, Bhalla AS et al (2012) Diffusion-weighted MRI in renal cell carcinoma: a surrogate marker for predicting nuclear grade and histological subtype. Acta Radiol 53:349–358

26.

Vargas HA, Chaim J, Lefkowitz RA et al (2012) Renal cortical tumors: use of multiphasic contrast-enhanced MR imaging to differentiate benign and malignant histologic subtypes. Radiology 264:779–788CrossRefPubMed

27.

Sun MR, Ngo L, Genega EM et al (2009) Renal cell carcinoma: dynamic contrast-enhanced MR imaging for differentiation of tumor subtypes--correlation with pathologic findings. Radiology 250:793–802CrossRefPubMed

28.

Wang H, Cheng L, Zhang X et al (2010) Renal cell carcinoma: diffusion-weighted MR imaging for subtype differentiation at 3.0 T. Radiology 257: 135–143.

29.

Squillaci E, Manenti G, Cova M et al (2004) Correlation of diffusion-weighted MR imaging with cellularity of renal tumours. Anticancer Res 24:4175–4179PubMed

30.

Lechevallier E, Andre M, Barriol D et al (2000) Fine-needle percutaneous biopsy of renal masses with helical CT guidance. Radiology 216:506–510CrossRefPubMed

31.

Eshed I, Elias S, Sidi AA (2004) Diagnostic value of CT-guided biopsy of indeterminate renal masses. Clin Radiol 59:262–267CrossRefPubMed

32.

Snyder ME, Bach A, Kattan MW et al (2006) Incidence of benign lesions for clinically localized renal masses smaller than 7 cm in radiological diameter: influence of sex. J Urol 176:2391–2395CrossRefPubMed

33.

Marszalek M, Ponholzer A, Brössner C et al (2004) Elective open nephron-sparing surgery for renal masses: single-center experience with 129 consecutive patients. Urology 64:38–42CrossRefPubMed

34.

Haifler M, Kutikov A (2017) Current role of renal biopsy in urologic practice. Urol Clin North Am 44:203–211CrossRefPubMed

35.

Patel HD, Druskin SC, Rowe SP et al (2017) Surgical histopathology for suspected oncocytoma on renal mass biopsy: a systematic review and meta-analysis. BJU Int 119:661–666CrossRefPubMed

Title: Diffusion-weighted imaging versus contrast-enhanced MR imaging for the differentiation of renal oncocytomas and chromophobe renal cell carcinomas
Authors: Yan Zhong
Haiyi Wang
Yanguang Shen
Aitao Guo
Jia Wang
Suhai Kang
Lu Ma
Jingjing Pan
Huiyi Ye
Publication date: 01-12-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 12/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4906-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diffusion-weighted imaging versus contrast-enhanced MR imaging for the differentiation of renal oncocytomas and chromophobe renal cell carcinomas

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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