Differential diagnosis of the small renal masses: role of the apparent diffusion coefficient of the diffusion-weighted MRI

Mytsyk, Yulian; Dutka, Ihor; Borys, Yuriy; Maksymovych, I.R.; Čaprnda, Martin; Gazdíková, Katarína; Rodrigo, Luís; Kružliak, Peter; ILLJUK, P.; Farooqı, Ammad Ahmad

doi:10.1007/s11255-017-1761-1

Cited by 25 publications

(18 citation statements)

References 13 publications

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“…In our study, all RCC cases showed restricted diffusion, with a mean ADC value of 1.5 ± 0.13×10 -3 mm 2 /s and range of 1.34×10-3 mm2/s -1.74×10 -3 mm 2 /s which is within the range as found in the previous study, with reported ADC values of 1.65 ± 0.38×10 -3 mm 2 /s. 19 However, lower ADC values were also reported in other previous studies. Inci et al surveyed RCC and found that the ADC value was 1.38×10 -3 mm 2 /s at a b value of 1000 s/mm 2 .…”

Section: Renal Cell Carcinomamentioning

confidence: 59%

Role of diffusion: weighted magnetic resonance imaging in evaluation of renal masses

Meena

Taneja

2020

Int J Res Med Sci

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Background: Diffusion-weighted magnetic resonance imaging (DWI) is a valuable tool to narrow down the differential diagnosis of renal masses. Studies have shown that benign renal masses have higher Apparent diffusion coefficient (ADC) value than malignant renal masses. Aim of study was to evaluate the role of diffusion-weighted magnetic resonance imaging in the characterization of renal masses.Methods: The study was conducted in department of Radio diagnosis at ABVIMS and Dr. RML Hospital, New Delhi between June 2017 to March 2019. This was a cross-sectional observational study comprising of 28 patients. Patients found to have renal mass on ultrasound and computed tomography (CT) were evaluated further on 3T siemens Magnetic resonance imaging (MRI) scanner. In addition to routine sequences, DWI using b value of 0,500,1000 s/mm2 sequence was used to study to differentiate benign and malignant renal masses.Results: Of a total of 28 cases, the most common malignant mass was renal cell carcinoma (RCC). Angiomyolipoma (AML) was the most common benign masses. DWI showed low ADC values in most of the malignant masses and high ADC values in most of the benign masses. The cut-off level of ADC value for differentiation among benign and malignant renal masses was 1.08×10-3 mm2/s. DWI-MR findings were correlated with histopathological diagnosis.Conclusion: DWI with ADC measurements are a non-invasive, problem solving tool for characterization of renal masses helping to differentiate malignant from benign masses.

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Section: Renal Cell Carcinomamentioning

confidence: 59%

Role of diffusion: weighted magnetic resonance imaging in evaluation of renal masses

Meena

Taneja

2020

Int J Res Med Sci

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“…anteromedial or perihilar tumour location) or biopsy is relatively contraindicated due to patient factors (single kidney, anticoagulation with a high risk of thrombosis if temporarily withheld). 1,20,27 In many such cases, surgical excision via partial or radical nephrectomy carries significant risk of major complications, quality of life effects and cost/resource burdens on health systems. 28 For these cases, performing an mpMRI that combines T1W, T2W, chemical shift (microscopic fat), diffusionweighted and contrast-enhanced parameters may narrow the differential diagnosis and indicate likely tumour subtype/s.…”

Section: Resultsmentioning

confidence: 99%

“…However, up to 33% of excised or biopsied renal masses have benign or indolent pathology. 1,2 Conventional imaging with CT and US cannot reliably differentiate benign or low-grade malignancies from high-grade malignancies. For example, benign oncocytomas, lipid-poor angiomyolipomas (AMLs) and RCCs can have very similar imaging findings.…”

Section: Introductionmentioning

confidence: 99%

Chemical shift imaging in the identification of those renal tumours that contain microscopic fat and the utility of multiparametric MRI in their differentiation

et al. 2020

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Introduction: The aim of this study was to assess the qualitative and MRI findings of renal tumours, to determine which lesions contain microscopic fat, one of the potential differentiating factors between tumour types. Methods: 73 patients who underwent 3 Tesla MRI including chemical shift imaging, with subsequent biopsy or excision for histopathological diagnosis, were included in the study. The images were reviewed for a decrease in signal intensity (SI) on the opposed phase compared with the in-phase gradient echo T1 images, indicating the presence of microscopic fat. The chemical shift index was then calculated as a percentage of SI change and compared with the pathological diagnosis. Results: In total, 38 (52%) of lesions demonstrated a decrease in SI, consistent with microscopic fat. Microscopic fat was found in 28 (80%) clear cell renal cell carcinomas (RCCs), 6 (66.7%) angiomyolipomas, 2 (20%) papillary RCCs, 1 (20%) chromophobe RCC and 1 (9.1%) oncocytoma. Pairwise comparison of means indicated that the amount of microscopic fat was significantly larger only for angiomyolipomas compared with clear cell RCCs (P < 0.001) and other renal lesions (P < 0.001). Conclusions: A decrease in SI on opposed phase compared with in-phase chemical shift imaging favours the diagnosis of either clear cell RCC or an angiomyolipoma. When combined with other parameters in mpMRI, this may aid differentiation of benign from malignant tumours and differentiation of aggressive from indolent RCC subtypes. This may be of value where biopsy is non-diagnostic, not feasible due to location or in high-risk patients.

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“…[ 7 , 8 ] Conventional ultrasound, computed tomography, and magnetic resonance imaging have been widely used to evaluate SRMs. [ 9 – 12 ]…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of contrast-enhanced ultrasound in the detection of small renal masses

Wu²,

Wang³

et al. 2020

Medicine

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Background: The small renal masses (SRMs) were defined that the diameter of renal masses measured by enhanced image was ≤4 cm. The diagnostic accuracy of contrast-enhanced ultrasound (CEUS) for SRMs is apparently variable among previous studies. Hence, this study will evaluate the diagnostic accuracy of CEUS in the identification of benign and malignant SRMs. Methods: A comprehensive search using the databases of Cochrane Library, Embase, PubMed, WANGFANG, and China National Knowledge Infrastructure will be carried out to identify studies in which patients with SRMs are assessed by CEUS. Two investigators will independently screen the literature and extract the data. Any discrepancies will be resolved via discussion with the senior author. Study quality will be assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 tool, and pooled sensitivity and specificity of various CEUS findings for the diagnosis of SRMs will be determined. Summary receiver operating characteristic curve will be used to assess the overall performance of CEUS. Results: This study will evaluate the diagnostic accuracy of CEUS for the diagnosis of SRMs through sensitivity, specificity, positive and negative likelihood ratio, and diagnostic odds ratio. Conclusion: This study will summarize the most recent evidence that focusing on the diagnosis of CEUS for SRMs. Study registration: INPLASY202060040.

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Differential diagnosis of the small renal masses: role of the apparent diffusion coefficient of the diffusion-weighted MRI

Cited by 25 publications

References 13 publications

Role of diffusion: weighted magnetic resonance imaging in evaluation of renal masses

Role of diffusion: weighted magnetic resonance imaging in evaluation of renal masses

Chemical shift imaging in the identification of those renal tumours that contain microscopic fat and the utility of multiparametric MRI in their differentiation

Diagnostic accuracy of contrast-enhanced ultrasound in the detection of small renal masses

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