The role of diffusion-weighted MRI and contrast-enhanced MRI for differentiation between solid renal masses and renal cell carcinoma subtypes

Serter A., ONUR M. R., ÇOBAN G., YILDIZ P., Armagan A., Kocakoc E.

ABDOMINAL RADIOLOGY, vol.46, no.3, pp.1041-1052, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 46 Issue: 3
  • Publication Date: 2021
  • Doi Number: 10.1007/s00261-020-02742-w
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1041-1052
  • Keywords: Kidney, Diffusion-weighted MRI, Magnetization transfer contrast imaging, Benign neoplasms, Malignant neoplasms, CLEAR-CELL, ANGIOMYOLIPOMA, FEATURES, CT, LESIONS
  • Hacettepe University Affiliated: Yes


Purpose To assess the value of diffusion-weighted magnetic resonance imaging (DW-MRI) and contrast-enhanced MRI (CE-MRI) for differentiation between benign and malignant solid renal masses, renal cell carcinoma (RCC) subtypes, oncocytomas, and lipid-poor angiomyolipomas (LP-AML). Methods Minimum or lowest 'apparent diffusion coefficient' (ADC(1)) and representative ADC values (ADC(2)) of 112 renal masses (n: 46 benign renal mass,n: 66 malignant renal mass) were measured on DW-MRI images (b50, 400, 800 s/mm(2)). Signal intensity (SI) measurements were performed in normal renal parenchyma and most avid enhanced area of the renal masses at precontrast, corticomedullary, and nephrographic phases on CE-MRI. Contrast enhancement rate (CER) and contrast enhancement index (CEI) values of renal masses were compared between benign-malignant renal masses and RCC subtypes, oncocytomas, and LP-AMLs. Results There was no significant difference between ADC(1), ADC(2)values, and SI of benign and malignant renal masses (p = 0.721,p = 0.255,p = 0.872). Mean ADC(1)and ADC(2)values of clear cell RCCs were significantly higher than nonclear cell RCCs (p = 0.005p = 0.002). Mean CER value of clear cell RCCs was significantly higher than nonclear cell RCCs in nephrographic phase (p = 0.003). Mean CEI values of clear cell RCCs were significantly higher than nonclear cell RCCs in the corticomedullary and nephrographic phase (p = 0.027 vs. 0.008). LP-AMLs were differentiated from other renal masses with wash-out phenomenon. Conclusion Combined usage of ADC, SI, CER, and CEI values may be useful for discrimination between RCC subtypes, oncocytomas, and lipid-poor AMLs.