PURPOSE: To retrospectively determine whether benign exophytic renal masses can be distinguished from renal cell carcinoma (RCC) on the basis of angular interface at single-shot fast spin-echo (SE) T2-weighted magnetic resonance (MR) imaging. MATERIALS AND METHODS: This retrospective study was compliant with HIPAA and was approved by the institutional review board. Patient informed consent was waived. A total of 162 exophytic (2 cm or greater) renal masses in 152 patients (103 men, 49 women; mean age, 58 years; age range, 23-85 years) were included. Two radiologists independently recorded the mass size and angular interface on single-shot fast SE T2-weighted MR images. Surgical pathologic report and MR follow-up were used as reference standards. Logistic regression analysis was used to examine the usefulness of these variables for differentiating benign masses from RCCs. Diagnostic performance was analyzed by comparing values for area under receiver operating characteristic curve (A(z)). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of angular interface for diagnosing benign masses were calculated. Reader agreement was assessed with kappa-weighted statistics and intraclass correlation coefficients (ICCs). RESULTS: Of 162 masses, 65 were benign, and 97 were RCCs. The sensitivity, specificity, PPV, NPV, and A(z) of angular interface for diagnosing benign masses were 78%, 100%, 100%, 87%, and 0.813, respectively. Angular interface (P < .001) was a significant predictor of benign renal mass but mass size (P = .66) was not. There was almost perfect interobserver agreement for mass size (ICC = 0.96) and angular interface (kappa = 0.91). CONCLUSION: The presence of an angular interface with the renal parenchyma at single-shot fast SE T2-weighted MR imaging is a strong predictor of benignity in an exophytic renal mass 2 cm or greater in diameter with high specificity and diagnostic accuracy.
PURPOSE: To retrospectively determine whether benign exophytic renal masses can be distinguished from renal cell carcinoma (RCC) on the basis of angular interface at single-shot fast spin-echo (SE) T2-weighted magnetic resonance (MR) imaging. MATERIALS AND METHODS: This retrospective study was compliant with HIPAA and was approved by the institutional review board. Patient informed consent was waived. A total of 162 exophytic (2 cm or greater) renal masses in 152 patients (103 men, 49 women; mean age, 58 years; age range, 23-85 years) were included. Two radiologists independently recorded the mass size and angular interface on single-shot fast SE T2-weighted MR images. Surgical pathologic report and MR follow-up were used as reference standards. Logistic regression analysis was used to examine the usefulness of these variables for differentiating benign masses from RCCs. Diagnostic performance was analyzed by comparing values for area under receiver operating characteristic curve (A(z)). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of angular interface for diagnosing benign masses were calculated. Reader agreement was assessed with kappa-weighted statistics and intraclass correlation coefficients (ICCs). RESULTS: Of 162 masses, 65 were benign, and 97 were RCCs. The sensitivity, specificity, PPV, NPV, and A(z) of angular interface for diagnosing benign masses were 78%, 100%, 100%, 87%, and 0.813, respectively. Angular interface (P < .001) was a significant predictor of benign renal mass but mass size (P = .66) was not. There was almost perfect interobserver agreement for mass size (ICC = 0.96) and angular interface (kappa = 0.91). CONCLUSION: The presence of an angular interface with the renal parenchyma at single-shot fast SE T2-weighted MR imaging is a strong predictor of benignity in an exophytic renal mass 2 cm or greater in diameter with high specificity and diagnostic accuracy.
Authors: Robert S Lim; Matthew D F McInnes; Mahadevaswamy Siddaiah; Trevor A Flood; Luke T Lavallee; Nicola Schieda Journal: Eur Radiol Date: 2018-02-28 Impact factor: 5.315
Authors: Kwang Ho Kim; Bu Hyeon Yun; Seung Il Jung; In Sang Hwang; Eu Chang Hwang; Taek Won Kang; Dong Deuk Kwon; Kwangsung Park; Jin Woong Kim Journal: Korean J Urol Date: 2013-08-07
Authors: Jae Hyeok Choi; Jong Won Kim; Joo Yong Lee; Woong Kyu Han; Koon Ho Rha; Young Deuk Choi; Sung Joon Hong; Young Eun Yoon Journal: Korean J Urol Date: 2015-10-06