Utility and limitations of 3-Tesla diffusion-weighted magnetic resonance imaging for differentiation of renal tumors

Sevcenco, Sabina; Heinz-Peer, Gertraud; Ponhold, Lothar; Javor, Domagoj; Kuehhas, Franklin E.; Klingler, H. Christoph; Remzi, Mesut; Weibl, Peter; Shariat, Shahrokh F.; Baltzer, Pascal

doi:10.1016/j.ejrad.2014.02.026

Cited by 49 publications

(29 citation statements)

References 26 publications

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“…Unclear risks of bias arose in several studies that allowed different reference standards for the diagnosis of positive and negative disease. These differences in reference standards included the use of surgical pathology versus percutaneous biopsy results, the use of imaging only for lesions considered to be Bosniak category II cysts, or the use of follow-up imaging for establishing benignity of Bosniak IIF cystic lesions [5,7,[16][17][18][19]. These differences in reference standards may have allowed incorrect classification in which lesions were presumed benign but possibly were indolent malignancies (e.g., oncocytic tumors diagnosed at biopsy or on imaging follow-up of variable lengths for complex renal cystic lesions) [20].…”

Section: Methodologic Qualitymentioning

confidence: 99%

DWI for Renal Mass Characterization: Systematic Review and Meta-Analysis of Diagnostic Test Performance

Kang

Zhang

Pandharipande

et al. 2015

American Journal of Roentgenology

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Evidence suggests moderate accuracy of DWI for the prediction of malignancy and high-grade clear cell cancers, whereas DWI performance for ascertaining clear cell histologic grade remains unclear. To develop DWI as a noninvasive approach for the evaluation of solid renal masses, prospective studies with standardized test parameters are needed to better establish DWI performance and its impact on patient outcomes.

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Section: Methodologic Qualitymentioning

confidence: 99%

DWI for Renal Mass Characterization: Systematic Review and Meta-Analysis of Diagnostic Test Performance

Kang

Zhang

Pandharipande

et al. 2015

American Journal of Roentgenology

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“…for this conclusion can be the exclusion of the cystic lesions from the relevant study and the discrepancy in the number and variety of the lesions when compared with our study (18). The limitations of our study were as follows.…”

Section: Resultsmentioning

confidence: 77%

The Role of Apparent Diffusion Coefficient Quantification in Differentiating Benign and Malignant Renal Masses by 3 Tesla Magnetic Resonance Imaging

et al. 2015

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Background: Diffusion-weighted magnetic resonance imaging (DWI) is a widely-accepted diagnostic modality whose efficacy has been investigated by numerous past studies in the differentiation of malignant lesions from benign entities. Aims: The aim of this study was to evaluate the efficiency of diffusion-weighted magnetic resonance imaging in the characterization of renal lesions. Study Design: Diagnostic accuracy study. Methods: A total of 137 patients with renal lesions were included in this study. The median apparent diffusion coefficient (ADC) values as well as the b 800 and b 1600 signal intensities of normal kidneys, solid components of mixed renal masses, and total cystic lesions were evaluated. Results: There were significant differences between the ADC values of lesions and normal renal parenchyma, and between the ADC values of benign and malignant renal lesions on DWIs at b values of 800 and 1600 s/mm² (p<0.001 and p<0.001, respectively). There were significant differences between the ADC values of Bosniak Category 1 and 2 cysts and the ADC values of Bosniak Category 1 and 3 cysts on DWIs at b values of 800 s/mm² (p<0.001) and 1600 s/mm 2 (p<0.001). A cutoff value of 1.902 x 10 -3 mm²/s for the ADC with a b value of 800 s/mm² provided 88% sensitivity and 96% specificity for differentiation between benign and malignant renal lesions. A cutoff value of 1.623 x 10 -3 mm²/s for the ADC with a b value of 1600 s/mm² provided 79% sensitivity and 96% specificity (p<0.001) for the differentiation between benign and malignant renal lesions. Conclusion: Accurate assessment of renal masses is important for determining the necessity for surgical intervention. DWI provides additional value by differentiating benign from malignant renal tumors and can be added to routine kidney MRI protocols.

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“…Mileto et al [16] defined a tumour iodine concentration of 0.9 mg/ml as the optimal threshold for discrimination between clear cell and pRCC on CT imaging. Sevcenco et al [17] also noted that diffusion-weighted imaging seems to help distinguish between papillary and other subtypes of RCCs, especially in small renal masses.…”

Section: Discussionmentioning

confidence: 99%

Morphological Characterization of Papillary Renal Cell Carcinoma Type 1, the Efficiency of Its Surgical Treatment

Procházková¹,

Staehler²,

Trávníček³

et al. 2016

Urol Int

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Aim: Papillary renal cell carcinoma type 1 (pRCC1) represents the second most common type of malignant renal epithelial tumour. The origin of its characteristic appearance, its growth mechanism, and the long-term efficiency of its surgical treatment remain uncertain. Our aim was to determine typical characteristics of surgically treated pRCC1. Methods: pRCC1 was verified in 83 of 1,629 (5.1%) kidney tumours surgically treated in the period of January 2007-January 2016. The clinical and radiological characteristics, type of surgery, histopathology results and follow up data were recorded. Spearman correlation, Kruskal-Wallis analysis of variance, Fisher's exact, and chi-square test were used to analyse appropriate variables. The overall survival rate was evaluated using the Gehan-Wilcoxon test and the Cox proportional hazards model. Results: The mean tumour size was 52.0 mm (15-180); 98.8% of the tumours showed a spherical shape and in 82.1%, exophytic growth was observed. Partial nephrectomy was performed in 80.7%. A majority (81.9%) were classified as pT1. Tumours, 89.2% of them, belonged to Fuhrman grade 1 or 2. The mean follow-up was 46.8 months. The overall survival was associated with pT category (p ≤ 0.0001). Conclusions: Typical signs of pRCC1 are a spherical shape, exophytic growth and low Fuhrman's grade. More than three-fourths of pRCC1 could be treated by the nephron-sparing surgery.

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Utility and limitations of 3-Tesla diffusion-weighted magnetic resonance imaging for differentiation of renal tumors

Cited by 49 publications

References 26 publications

DWI for Renal Mass Characterization: Systematic Review and Meta-Analysis of Diagnostic Test Performance

DWI for Renal Mass Characterization: Systematic Review and Meta-Analysis of Diagnostic Test Performance

The Role of Apparent Diffusion Coefficient Quantification in Differentiating Benign and Malignant Renal Masses by 3 Tesla Magnetic Resonance Imaging

Morphological Characterization of Papillary Renal Cell Carcinoma Type 1, the Efficiency of Its Surgical Treatment

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