Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging to Identify Clear Cell Renal Cell Carcinoma in cT1a Renal Masses

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24 Citations (Scopus)

Abstract

Purpose: The detection of small renal masses is increasing with the use of cross-sectional imaging, although many incidental lesions have negligible metastatic potential. Among malignant masses clear cell renal cell carcinoma is the most prevalent and aggressive subtype. A method to identify such histology would aid in risk stratification. Our goal was to evaluate a likelihood scale for multiparametric magnetic resonance imaging in the diagnosis of clear cell histology. Materials and Methods: We retrospectively reviewed the records of patients with cT1a masses who underwent magnetic resonance imaging and partial or radical nephrectomy from December 2011 to July 2015. Seven radiologists with different levels of experience who were blinded to final pathology findings independently reviewed studies based on a predefined algorithm. They applied a clear cell likelihood score, including 1-definitely not, 2-probably not, 3-equivocal, 4-probably and 5-definitely. Binary classification was used to determine the accuracy of clear cell vs all other histologies. Interobserver agreement was calculated with the weighted κ statistic. Results: A total of 110 patients with 121 masses were identified. Mean tumor size was 2.4 cm and 50% of the lesions were clear cell. Defining clear cell as scores of 4 or greater demonstrated 78% sensitivity and 80% specificity while scores of 3 or greater showed 95% sensitivity and 58% specificity. Interobserver agreement was moderate to good with a mean κ of 0.53. Conclusions: A clear cell likelihood score used with magnetic resonance imaging can reasonably identify clear cell histology in small renal masses and may decrease the number of diagnostic renal mass biopsies. Standardization of imaging protocols and reporting criteria is needed to improve interobserver reliability.

Original languageEnglish (US)
JournalJournal of Urology
DOIs
StateAccepted/In press - 2017

Fingerprint

Renal Cell Carcinoma
Magnetic Resonance Imaging
Kidney
Histology
Sensitivity and Specificity
Nephrectomy
Pathology
Biopsy
Neoplasms

Keywords

  • Carcinoma
  • Histology
  • Kidney neoplasms
  • Magnetic resonance imaging
  • Neoplasm metastasis
  • Renal cell

ASJC Scopus subject areas

  • Urology

Cite this

@article{34148f4ef5654cd78811e83c1b32a6c8,
title = "Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging to Identify Clear Cell Renal Cell Carcinoma in cT1a Renal Masses",
abstract = "Purpose: The detection of small renal masses is increasing with the use of cross-sectional imaging, although many incidental lesions have negligible metastatic potential. Among malignant masses clear cell renal cell carcinoma is the most prevalent and aggressive subtype. A method to identify such histology would aid in risk stratification. Our goal was to evaluate a likelihood scale for multiparametric magnetic resonance imaging in the diagnosis of clear cell histology. Materials and Methods: We retrospectively reviewed the records of patients with cT1a masses who underwent magnetic resonance imaging and partial or radical nephrectomy from December 2011 to July 2015. Seven radiologists with different levels of experience who were blinded to final pathology findings independently reviewed studies based on a predefined algorithm. They applied a clear cell likelihood score, including 1-definitely not, 2-probably not, 3-equivocal, 4-probably and 5-definitely. Binary classification was used to determine the accuracy of clear cell vs all other histologies. Interobserver agreement was calculated with the weighted κ statistic. Results: A total of 110 patients with 121 masses were identified. Mean tumor size was 2.4 cm and 50{\%} of the lesions were clear cell. Defining clear cell as scores of 4 or greater demonstrated 78{\%} sensitivity and 80{\%} specificity while scores of 3 or greater showed 95{\%} sensitivity and 58{\%} specificity. Interobserver agreement was moderate to good with a mean κ of 0.53. Conclusions: A clear cell likelihood score used with magnetic resonance imaging can reasonably identify clear cell histology in small renal masses and may decrease the number of diagnostic renal mass biopsies. Standardization of imaging protocols and reporting criteria is needed to improve interobserver reliability.",
keywords = "Carcinoma, Histology, Kidney neoplasms, Magnetic resonance imaging, Neoplasm metastasis, Renal cell",
author = "Canvasser, {Noah E.} and Kay, {Fernando Uliana} and Yin Xi and Pinho, {Daniella F} and Costa, {Daniel N} and {Diaz De Leon III}, Alberto and Gaurav Khatri and John Leyendecker and Takeshi Yokoo and Aaron Lay and Nicholas Kavoussi and Ersin Koseoglu and Cadeddu, {Jeffrey A} and Ivan Pedrosa",
year = "2017",
doi = "10.1016/j.juro.2017.04.089",
language = "English (US)",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging to Identify Clear Cell Renal Cell Carcinoma in cT1a Renal Masses

AU - Canvasser, Noah E.

AU - Kay, Fernando Uliana

AU - Xi, Yin

AU - Pinho, Daniella F

AU - Costa, Daniel N

AU - Diaz De Leon III, Alberto

AU - Khatri, Gaurav

AU - Leyendecker, John

AU - Yokoo, Takeshi

AU - Lay, Aaron

AU - Kavoussi, Nicholas

AU - Koseoglu, Ersin

AU - Cadeddu, Jeffrey A

AU - Pedrosa, Ivan

PY - 2017

Y1 - 2017

N2 - Purpose: The detection of small renal masses is increasing with the use of cross-sectional imaging, although many incidental lesions have negligible metastatic potential. Among malignant masses clear cell renal cell carcinoma is the most prevalent and aggressive subtype. A method to identify such histology would aid in risk stratification. Our goal was to evaluate a likelihood scale for multiparametric magnetic resonance imaging in the diagnosis of clear cell histology. Materials and Methods: We retrospectively reviewed the records of patients with cT1a masses who underwent magnetic resonance imaging and partial or radical nephrectomy from December 2011 to July 2015. Seven radiologists with different levels of experience who were blinded to final pathology findings independently reviewed studies based on a predefined algorithm. They applied a clear cell likelihood score, including 1-definitely not, 2-probably not, 3-equivocal, 4-probably and 5-definitely. Binary classification was used to determine the accuracy of clear cell vs all other histologies. Interobserver agreement was calculated with the weighted κ statistic. Results: A total of 110 patients with 121 masses were identified. Mean tumor size was 2.4 cm and 50% of the lesions were clear cell. Defining clear cell as scores of 4 or greater demonstrated 78% sensitivity and 80% specificity while scores of 3 or greater showed 95% sensitivity and 58% specificity. Interobserver agreement was moderate to good with a mean κ of 0.53. Conclusions: A clear cell likelihood score used with magnetic resonance imaging can reasonably identify clear cell histology in small renal masses and may decrease the number of diagnostic renal mass biopsies. Standardization of imaging protocols and reporting criteria is needed to improve interobserver reliability.

AB - Purpose: The detection of small renal masses is increasing with the use of cross-sectional imaging, although many incidental lesions have negligible metastatic potential. Among malignant masses clear cell renal cell carcinoma is the most prevalent and aggressive subtype. A method to identify such histology would aid in risk stratification. Our goal was to evaluate a likelihood scale for multiparametric magnetic resonance imaging in the diagnosis of clear cell histology. Materials and Methods: We retrospectively reviewed the records of patients with cT1a masses who underwent magnetic resonance imaging and partial or radical nephrectomy from December 2011 to July 2015. Seven radiologists with different levels of experience who were blinded to final pathology findings independently reviewed studies based on a predefined algorithm. They applied a clear cell likelihood score, including 1-definitely not, 2-probably not, 3-equivocal, 4-probably and 5-definitely. Binary classification was used to determine the accuracy of clear cell vs all other histologies. Interobserver agreement was calculated with the weighted κ statistic. Results: A total of 110 patients with 121 masses were identified. Mean tumor size was 2.4 cm and 50% of the lesions were clear cell. Defining clear cell as scores of 4 or greater demonstrated 78% sensitivity and 80% specificity while scores of 3 or greater showed 95% sensitivity and 58% specificity. Interobserver agreement was moderate to good with a mean κ of 0.53. Conclusions: A clear cell likelihood score used with magnetic resonance imaging can reasonably identify clear cell histology in small renal masses and may decrease the number of diagnostic renal mass biopsies. Standardization of imaging protocols and reporting criteria is needed to improve interobserver reliability.

KW - Carcinoma

KW - Histology

KW - Kidney neoplasms

KW - Magnetic resonance imaging

KW - Neoplasm metastasis

KW - Renal cell

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U2 - 10.1016/j.juro.2017.04.089

DO - 10.1016/j.juro.2017.04.089

M3 - Article

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

ER -