Use of DWI in the Differentiation of Renal Cortical Tumors
| Autor: | Andreas Wibmer, Oguz Akin, Junting Zheng, Hedvig Hricak, Chaya S. Moskowitz, Paul Russo, Andreas M. Hötker, Satish K. Tickoo, Yousef Mazaheri |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Wilcoxon signed-rank test medicine.medical_treatment Nephrectomy Article 030218 nuclear medicine & medical imaging Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Renal cell carcinoma Image Interpretation Computer-Assisted Preoperative Care medicine Humans Effective diffusion coefficient Radiology Nuclear Medicine and imaging Carcinoma Renal Cell Retrospective Studies business.industry Cancer General Medicine Middle Aged Image Enhancement medicine.disease Kidney Neoplasms Clear cell renal cell carcinoma Diffusion Magnetic Resonance Imaging Concordance correlation coefficient 030220 oncology & carcinogenesis Female Radiology business Clear cell |
| Zdroj: | American Journal of Roentgenology. 206:100-105 |
| ISSN: | 1546-3141 0361-803X |
| Popis: | The purpose of this study was to differentiate clear cell renal cell carcinoma (RCC) from other common renal cortical tumors by use of DWI.The study included 117 patients (mean age, 60 years) with 122 histopathologically confirmed renal cortical tumors who underwent 1.5-T MRI that included DWI before they underwent nephrectomy between 2006 and 2013. For each tumor, two radiologists independently evaluated apparent diffusion coefficient (ADC) values on the basis of a single ROI in a nonnecrotic area of the tumor and also by assessment of the whole tumor. The concordance correlation coefficient (CCC) was calculated to assess interreader agreement. The mean ADC values of clear cell RCC and every other tumor subtype were compared using an exact Wilcoxon rank sum test.Interreader agreement was excellent and higher in whole-tumor assessment (CCC, 0.982) than in single-ROI analysis (CCC, 0.756). For both readers, ADC values for clear cell RCC found on single-ROI assessment (2.19 and 2.08 × 10(-3) mm(2)/s) and whole-tumor assessment (2.30 and 2.32 × 10(-3) mm(2)/s) were statistically significantly higher than those for chromophobe, papillary, or unclassified RCC (p0.05) but were similar to those for oncocytoma found on single-ROI assessment (2.14 and 2.32 × 10(-3) mm(2)/s) and whole-tumor assessment (2.38 and 2.24 × 10(-3) mm(2)/s). ADC values were also higher for clear cell RCC than for angiomyolipoma, but the difference was statistically significant only in whole-tumor assessment (p0.03).ADC values were statistically significantly higher for clear cell RCC than for chromophobe, papillary, or unclassified RCC subtypes; however, differentiating clear cell RCC from oncocytoma by use of DWI remains especially challenging, because similar ADC values have been shown for these two tumor types. |
| Databáze: | OpenAIRE |
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