Diagnostic performance of prospectively assigned clear cell Likelihood scores (ccLS) in small renal masses at multiparametric magnetic resonance imaging

Research output: Contribution to journalArticle

Abstract

Introduction: Detection of small renal masses (SRM) is increasing with the use of cross-sectional imaging, although many incidental lesions have negligible metastatic potential. A method to identify this subtype would aid in risk stratification. A previously reported clear cell likelihood score (ccLS; 1-very unlikely, 2-unlikely, 3-equivocal, 4-likely, and 5-very likely), based on retrospective review of multiparametric magnetic resonance imaging (mpMRI), predicted the likelihood of encountering clear cell renal cell carcinoma (ccRCC) at surgery. Here, we assess the performance of ccLS prospectively assigned for prediction of ccRCC. Methods: Patients with a known renal mass who underwent mpMRI at a single institution between June 2016 and April 2018 were prospectively assigned a ccLS as part of the clinical MRI report. These patients were retrospectively reviewed, and those with a cT1a lesion and available pathological tissue diagnosis (diagnostic biopsy or extirpative surgery) were selected for analysis. Results: In total, 57 patients (mean age 61.7 ± 14.9 years) with 63 cT1a renal masses were identified. Mean tumor size was 2.7 ± 0.7 cm. Defining ccLS 4-5 lesions as positive demonstrated an overall accuracy of 84%, sensitivity of 89%, specificity of 79%, positive predictive value of 84%, and negative predictive value of 86%. A ccLS of 1-2 demonstrates an 86% accuracy and 100% sensitivity/positive predictive value of identifying non-ccRCC histology. Conclusions: Utilizing prospectively assigned ccLS, we confirm that mpMRI can reasonably identify ccRCC histology in cT1a renal masses. Standardization of imaging protocols and reporting criteria such as the ccLS can be used to aid in the diagnosis and management of small renal masses.

Original languageEnglish (US)
JournalUrologic Oncology: Seminars and Original Investigations
DOIs
StateAccepted/In press - Jan 1 2019

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

Keywords

  • Clear Cell Likelihood Score
  • Multiparametric Magnetic
  • Partial Nephrectomy
  • Renal Cell Carcinoma
  • Renal Mass Biopsy
  • Resonance Imaging
  • Small Renal Mass

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

@article{d57f7f40f1ec44c1aef185f380c51a90,
title = "Diagnostic performance of prospectively assigned clear cell Likelihood scores (ccLS) in small renal masses at multiparametric magnetic resonance imaging",
abstract = "Introduction: Detection of small renal masses (SRM) is increasing with the use of cross-sectional imaging, although many incidental lesions have negligible metastatic potential. A method to identify this subtype would aid in risk stratification. A previously reported clear cell likelihood score (ccLS; 1-very unlikely, 2-unlikely, 3-equivocal, 4-likely, and 5-very likely), based on retrospective review of multiparametric magnetic resonance imaging (mpMRI), predicted the likelihood of encountering clear cell renal cell carcinoma (ccRCC) at surgery. Here, we assess the performance of ccLS prospectively assigned for prediction of ccRCC. Methods: Patients with a known renal mass who underwent mpMRI at a single institution between June 2016 and April 2018 were prospectively assigned a ccLS as part of the clinical MRI report. These patients were retrospectively reviewed, and those with a cT1a lesion and available pathological tissue diagnosis (diagnostic biopsy or extirpative surgery) were selected for analysis. Results: In total, 57 patients (mean age 61.7 ± 14.9 years) with 63 cT1a renal masses were identified. Mean tumor size was 2.7 ± 0.7 cm. Defining ccLS 4-5 lesions as positive demonstrated an overall accuracy of 84{\%}, sensitivity of 89{\%}, specificity of 79{\%}, positive predictive value of 84{\%}, and negative predictive value of 86{\%}. A ccLS of 1-2 demonstrates an 86{\%} accuracy and 100{\%} sensitivity/positive predictive value of identifying non-ccRCC histology. Conclusions: Utilizing prospectively assigned ccLS, we confirm that mpMRI can reasonably identify ccRCC histology in cT1a renal masses. Standardization of imaging protocols and reporting criteria such as the ccLS can be used to aid in the diagnosis and management of small renal masses.",
keywords = "Clear Cell Likelihood Score, Multiparametric Magnetic, Partial Nephrectomy, Renal Cell Carcinoma, Renal Mass Biopsy, Resonance Imaging, Small Renal Mass",
author = "Johnson, {Brett A.} and Sandy Kim and Steinberg, {Ryan L.} and {de Leon}, {Alberto Diaz} and Ivan Pedrosa and Cadeddu, {Jeffrey A.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.urolonc.2019.07.023",
language = "English (US)",
journal = "Urologic Oncology: Seminars and Original Investigations",
issn = "1078-1439",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Diagnostic performance of prospectively assigned clear cell Likelihood scores (ccLS) in small renal masses at multiparametric magnetic resonance imaging

AU - Johnson, Brett A.

AU - Kim, Sandy

AU - Steinberg, Ryan L.

AU - de Leon, Alberto Diaz

AU - Pedrosa, Ivan

AU - Cadeddu, Jeffrey A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: Detection of small renal masses (SRM) is increasing with the use of cross-sectional imaging, although many incidental lesions have negligible metastatic potential. A method to identify this subtype would aid in risk stratification. A previously reported clear cell likelihood score (ccLS; 1-very unlikely, 2-unlikely, 3-equivocal, 4-likely, and 5-very likely), based on retrospective review of multiparametric magnetic resonance imaging (mpMRI), predicted the likelihood of encountering clear cell renal cell carcinoma (ccRCC) at surgery. Here, we assess the performance of ccLS prospectively assigned for prediction of ccRCC. Methods: Patients with a known renal mass who underwent mpMRI at a single institution between June 2016 and April 2018 were prospectively assigned a ccLS as part of the clinical MRI report. These patients were retrospectively reviewed, and those with a cT1a lesion and available pathological tissue diagnosis (diagnostic biopsy or extirpative surgery) were selected for analysis. Results: In total, 57 patients (mean age 61.7 ± 14.9 years) with 63 cT1a renal masses were identified. Mean tumor size was 2.7 ± 0.7 cm. Defining ccLS 4-5 lesions as positive demonstrated an overall accuracy of 84%, sensitivity of 89%, specificity of 79%, positive predictive value of 84%, and negative predictive value of 86%. A ccLS of 1-2 demonstrates an 86% accuracy and 100% sensitivity/positive predictive value of identifying non-ccRCC histology. Conclusions: Utilizing prospectively assigned ccLS, we confirm that mpMRI can reasonably identify ccRCC histology in cT1a renal masses. Standardization of imaging protocols and reporting criteria such as the ccLS can be used to aid in the diagnosis and management of small renal masses.

AB - Introduction: Detection of small renal masses (SRM) is increasing with the use of cross-sectional imaging, although many incidental lesions have negligible metastatic potential. A method to identify this subtype would aid in risk stratification. A previously reported clear cell likelihood score (ccLS; 1-very unlikely, 2-unlikely, 3-equivocal, 4-likely, and 5-very likely), based on retrospective review of multiparametric magnetic resonance imaging (mpMRI), predicted the likelihood of encountering clear cell renal cell carcinoma (ccRCC) at surgery. Here, we assess the performance of ccLS prospectively assigned for prediction of ccRCC. Methods: Patients with a known renal mass who underwent mpMRI at a single institution between June 2016 and April 2018 were prospectively assigned a ccLS as part of the clinical MRI report. These patients were retrospectively reviewed, and those with a cT1a lesion and available pathological tissue diagnosis (diagnostic biopsy or extirpative surgery) were selected for analysis. Results: In total, 57 patients (mean age 61.7 ± 14.9 years) with 63 cT1a renal masses were identified. Mean tumor size was 2.7 ± 0.7 cm. Defining ccLS 4-5 lesions as positive demonstrated an overall accuracy of 84%, sensitivity of 89%, specificity of 79%, positive predictive value of 84%, and negative predictive value of 86%. A ccLS of 1-2 demonstrates an 86% accuracy and 100% sensitivity/positive predictive value of identifying non-ccRCC histology. Conclusions: Utilizing prospectively assigned ccLS, we confirm that mpMRI can reasonably identify ccRCC histology in cT1a renal masses. Standardization of imaging protocols and reporting criteria such as the ccLS can be used to aid in the diagnosis and management of small renal masses.

KW - Clear Cell Likelihood Score

KW - Multiparametric Magnetic

KW - Partial Nephrectomy

KW - Renal Cell Carcinoma

KW - Renal Mass Biopsy

KW - Resonance Imaging

KW - Small Renal Mass

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U2 - 10.1016/j.urolonc.2019.07.023

DO - 10.1016/j.urolonc.2019.07.023

M3 - Article

C2 - 31540830

AN - SCOPUS:85072193847

JO - Urologic Oncology: Seminars and Original Investigations

JF - Urologic Oncology: Seminars and Original Investigations

SN - 1078-1439

ER -