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01-06-2013 | Urogenital

MR imaging of renal cortical tumours: qualitative and quantitative chemical shift imaging parameters

Authors: Christoph A. Karlo, Olivio F. Donati, Irene A. Burger, Junting Zheng, Chaya S. Moskowitz, Hedvig Hricak, Oguz Akin

Published in: European Radiology | Issue 6/2013

Abstract

Objectives

To assess qualitative and quantitative chemical shift MRI parameters of renal cortical tumours.

Methods

A total of 251 consecutive patients underwent 1.5-T MRI before nephrectomy. Two readers (R1, R2) independently evaluated all tumours visually for a decrease in signal intensity (SI) on opposed- compared with in-phase chemical shift images. In addition, SI was measured on in- and opposed-phase images (SI^IP, SI^OP) and the chemical shift index was calculated as a measure of percentage SI change. Histopathology served as the standard of reference.

Results

A visual decrease in SI was identified significantly more often in clear cell renal cell carcinoma (RCCs) (R1, 73 %; R2, 64 %) and angiomyolipomas (both, 80 %) than in oncocytomas (29 %, 12 %), papillary (29 %, 17 %) and chromophobe RCCs (13 %, 9 %; all, P < 0.05). Median chemical shift index was significantly greater in clear cell RCC and angiomyolipoma than in the other histological subtypes (both, P < 0.001). Interobserver agreement was fair for visual (kappa, 0.4) and excellent for quantitative analysis (concordance correlation coefficient, 0.80).

Conclusions

A decrease in SI on opposed-phase chemical shift images is not an identifying feature of clear cell RCCs or angiomyolipomas, but can also be observed in oncocytomas, papillary and chromophobe RCCs. After excluding angiomyolipomas, a decrease in SI of more than 25 % was diagnostic for clear cell RCCs.

Key Points

• Chemical shift MRI offers new information about fat within renal tumours.

• Opposed-phase signal decrease can be observed in all renal cortical tumours.

• A greater than 25 % decrease in signal appears to be diagnostic for clear cell RCCs

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Title: MR imaging of renal cortical tumours: qualitative and quantitative chemical shift imaging parameters
Authors: Christoph A. Karlo
Olivio F. Donati
Irene A. Burger
Junting Zheng
Chaya S. Moskowitz
Hedvig Hricak
Oguz Akin
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: European Radiology / Issue 6/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2758-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

MR imaging of renal cortical tumours: qualitative and quantitative chemical shift imaging parameters

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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