Yan Zhong1, Haiyi Wang1, Yanguang Shen1, Aitao Guo2, Jia Wang3, Suhai Kang4, Lu Ma1, Jingjing Pan1, Huiyi Ye5. 1. Department of Radiology, Chinese PLA General Hospital, Fuxing Road 28, Box 100853, Beijing, China. 2. Department of Pathology, Chinese PLA General Hospital, Fuxing Road 28, Beijing, China. 3. Department of Radiology, Handan Central Hosptical, Zhonghua Street 15, Box 056001, Hebei, China. 4. X-ray Department, 264 Hospital of PLA, Qiaodong Street, Box 030001, Taiyuan, China. 5. Department of Radiology, Chinese PLA General Hospital, Fuxing Road 28, Box 100853, Beijing, China. 13701100368@163.com.
Abstract
OBJECTIVES: To compare the performance of diffusion-weighted imaging (DWI) with that of contrast-enhanced MRI in differentiating renal oncocytomas from chromophobe renal cell carcinomas (RCCs). METHODS: We recruited 48 patients with histopathologically confirmed renal oncocytomas (n=16) and chromophobe RCCs (n=32). All patients underwent preoperative DWI and contrast-enhanced MRI. Apparent diffusion coefficient (ADC) and signal intensity were measured in each patient. ADC ratio and percentage of signal intensity change were calculated. RESULTS: Mean ADC values for renal oncoctytomas were significantly higher than those for chromophobe RCCs (1.59±0.21 vs. 1.09±0.29× 10-3 mm2/s, p < 0.001). Area under the ROC curve, sensitivity and specificity were 0.931, 87.5% and 84.4%, respectively, for ADC measurement of DW imaging; 0.825, 87.5% and 75%, respectively, for enhancement ratio (p > 0.05). Adding ADC values to the enhancement ratios in the ROC, analysis to differentiate renal oncocytoma from chromophobe RCCs increased specificity from 75 to 87.5% at 87.5% sensitivity without significantly increasing the AUC (0.930). CONCLUSIONS: Both DWI and contrast-enhanced MRI may assist in differentiating renal oncocytomas from chromophobe RCCs, with DWI showing higher diagnostic value. The combination of the two parameters could potentially provide better performance in distinguishing these two tumours. KEY POINTS: • ADC values can assist in differentiating renal oncocytomas from chromophobe RCCs. • DW imaging possesses better specificity than does contrast-enhanced MR imaging. • Combining the two parameters provides higher specificity regarding the differential diagnosis.
OBJECTIVES: To compare the performance of diffusion-weighted imaging (DWI) with that of contrast-enhanced MRI in differentiating renal oncocytomas from chromophobe renal cell carcinomas (RCCs). METHODS: We recruited 48 patients with histopathologically confirmed renal oncocytomas (n=16) and chromophobe RCCs (n=32). All patients underwent preoperative DWI and contrast-enhanced MRI. Apparent diffusion coefficient (ADC) and signal intensity were measured in each patient. ADC ratio and percentage of signal intensity change were calculated. RESULTS: Mean ADC values for renal oncoctytomas were significantly higher than those for chromophobe RCCs (1.59±0.21 vs. 1.09±0.29× 10-3 mm2/s, p < 0.001). Area under the ROC curve, sensitivity and specificity were 0.931, 87.5% and 84.4%, respectively, for ADC measurement of DW imaging; 0.825, 87.5% and 75%, respectively, for enhancement ratio (p > 0.05). Adding ADC values to the enhancement ratios in the ROC, analysis to differentiate renal oncocytoma from chromophobe RCCs increased specificity from 75 to 87.5% at 87.5% sensitivity without significantly increasing the AUC (0.930). CONCLUSIONS: Both DWI and contrast-enhanced MRI may assist in differentiating renal oncocytomas from chromophobe RCCs, with DWI showing higher diagnostic value. The combination of the two parameters could potentially provide better performance in distinguishing these two tumours. KEY POINTS: • ADC values can assist in differentiating renal oncocytomas from chromophobe RCCs. • DW imaging possesses better specificity than does contrast-enhanced MR imaging. • Combining the two parameters provides higher specificity regarding the differential diagnosis.
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