T1-hyperintense renal lesions: can high signal predict lack of enhancement?

Le, Jenna; Flusberg, Milana; Rozenblit, Alla M.; Chernyak, Victoria

doi:10.1007/s00261-015-0539-0

Cited by 4 publications

(1 citation statement)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Specifically, papillary renal cell carcinoma has a propensity to show intralesional hemorrhage [18,23], and accounted for 57% of our malignant masses, despite only representing 10-15% of all renal cell carcinoma [24]. Prior studies examining T1-hyperintense renal lesions similarly reported enriched proportions of papillary renal cell carcinoma, ranging from 32% to 46% [25,26]. Furthermore, studies focusing on papillary renal cell carcinomas showed high frequencies of T1 hyperintensity [27,28].…”

Section: Discussionmentioning

confidence: 97%

Apparent Diffusion Coefficient Distinguishes Malignancy in T1-Hyperintense Small Renal Masses

Ludwig

Ballard

Shetty

et al. 2020

American Journal of Roentgenology

View full text Add to dashboard Cite

OBJECTIVE.-Small renal masses (< 4 cm) can be difficult to accurately classify as benign or malignant, particularly when they appear T1 hyperintense on MRI. This intrinsic signal, potentially related to intralesional hemorrhage, may limit evaluation of signal intensity on DWI. The purpose of this study was to test whether apparent diffusion coefficient (ADC) measurements may distinguish malignancy. MATERIALS AND METHODS.-This single-center retrospective study identified patients with a T1-hyperintense renal mass less than 4 cm on MRI. Malignant lesions were pathologically proven; a benign mass was established by a predefined hierarchy of pathologic proof, follow-up ultrasound, or follow-up imaging showing more than 5 years of stability. T1 hyperintensity, defined as a signal intensity equivalent to or greater than the adjacent renal cortex, was confirmed by a senior abdominal radiologist. Two additional abdominal radiologists independently measured ADC of the lesion, which was normalized to the ADC of the background ipsilateral kidney and represented as ADC ratio .RESULTS.-The final cohort included 58 benign and 37 malignant renal lesions in 95 patients. Interrater agreement for ADC measurements was almost perfect (κ = 0.836-0.934). ADC ratio was significantly lower in malignant compared with benign lesions (0.65 ± 0.29 vs 1.03 ± 0.32; p < 0.001). Malignant lesions were significantly larger than benign lesions (2.66 ± 0.86 cm vs 1.50 ± 0.65 cm; p < 0.001); however, after controlling for lesion size, ADC ratio remained a significant predictor of malignancy (p < 0.001).CONCLUSION.-ADC ratio was highly reproducible for T1-hyperintense small renal masses and was significantly lower in malignant compared with benign renal masses.

show abstract

Section: Discussionmentioning

confidence: 97%

Apparent Diffusion Coefficient Distinguishes Malignancy in T1-Hyperintense Small Renal Masses

Ludwig

Ballard

Shetty

et al. 2020

American Journal of Roentgenology

View full text Add to dashboard Cite

show abstract

Diagnostic accuracy of the Clear Cell Likelihood Score and selected MRI parameters in the characterization of indeterminate renal masses – a single-institution study

Blachura,

Matusik,

Kowal

et al. 2024

Abdom Radiol

View full text Add to dashboard Cite

Purpose We aimed to assess the diagnostic accuracy of the clear cell likelihood score (ccLS) and value of other selected magnetic resonance imaging (MRI) features in the characterization of indeterminate small renal masses (SRMs). Methods Fifty patients with indeterminate SRMs discovered on MRI between 2012 and 2023 were included. The ccLS for the characterization of clear cell renal cell carcinoma (ccRCC) was calculated and compared to the final diagnosis (ccRCC vs. ‘all other’ masses). Results The ccLS = 5 had a satisfactory accuracy of 64.0% and a very high specificity of 96.3%; however, its sensitivity of 26.1% was relatively low. Receiver operating curve (ROC) analysis revealed that from the selected MRI features, only T1 ratio and arterial to delayed enhancement (ADER) were good discriminators between ccRCC and other types of renal masses (area under curve, AUC = 0.707, p = 0.01; AUC = 0.673, p = 0.03; respectively). The cut-off points determined in ROC analysis using the Youden index were 0.73 (p = 0.01) for T1 ratio and 0.99 for ADER (p = 0.03). The logistic regression model demonstrated that ccLS = 5 and T1 ratio (OR = 15.5 [1.1-218.72], p = 0.04; OR = 0.002 [0.00-0.81], p = 0.04) were significant predictors of ccRCC. Conclusions The ccLS algorithm offers an encouraging method for the standardization of imaging protocols to aid in the diagnosis and management of SRMs in daily clinical practice by enhancing detectability of ccRCC and reducing the number of unnecessary invasive procedures for benign or indolent lesions. However, its diagnostic performance needs multi-center large cohort studies to validate it before it can be incorporated as a diagnostic algorithm and will guide future iterations of clinical guidelines. The retrospective nature of our study and small patient population confined to a single clinical center may impact the generalizability of the results; thus, future studies are required to define whether employment of the T1 ratio or ADER parameter may strengthen the diagnostic accuracy of ccRCC diagnosis. Graphical Abstract

show abstract

Visual Assessment of the Intensity and Pattern of T1 Hyperintensity on MRI to Differentiate Hemorrhagic Renal Cysts From Renal Cell Carcinoma

Kim

Shanbhogue

Schreiber-Zinaman

et al. 2017

American Journal of Roentgenology

View full text Add to dashboard Cite

show abstract

T1-hyperintense renal lesions: can high signal predict lack of enhancement?

Abstract: Signal ratio of lesion to cortex ≥ 2.15 on unenhanced T1-weighted images is a highly specific predictor for non-enhancement.

Cited by 4 publications

References 11 publications

Apparent Diffusion Coefficient Distinguishes Malignancy in T1-Hyperintense Small Renal Masses

Apparent Diffusion Coefficient Distinguishes Malignancy in T1-Hyperintense Small Renal Masses

Diagnostic accuracy of the Clear Cell Likelihood Score and selected MRI parameters in the characterization of indeterminate renal masses – a single-institution study

Visual Assessment of the Intensity and Pattern of T1 Hyperintensity on MRI to Differentiate Hemorrhagic Renal Cysts From Renal Cell Carcinoma

Contact Info

Product

Resources

About