Differential diagnostics of the small renal masses: efficiency of application of the apparent diffusion coefficient of the diffusion weighted MRI as imaging biomarker of the renal cell carcinoma
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Abstract
Differential diagnostics of the small renal masses (SRM) is an impor tant issue of contemporary urologic practice. Part of the non diagnos tic percutaneous puncture biopsies varies from 10 to 23%, at the same time 7,5 33% of the partial nephrectomies due to malignancy suspicion in patients with SRM are performed on benign lesions. Pathologically renal cell carcinoma (RCC) is diagnosed in 48 66% patients with SRM.
The objective: the goal of the study was to evaluate the efficiency of application of the apparent diffusion coefficient (ADC) of the diffu sion weighted imaging (DWI) of MRI as imaging biomarker of the RCC in differential diagnostics of the SRM.
Patients and methods. In total 158 adult patients with 171 SRM were enrolled into study: 80 (50,63%) patients with solid RCC – 55 (34,81%) with clear cell RCC, 13 (8,23%) with papillary RCC, 12 (7,59%) with chromophobe RCC; 25 (15,82%) patients with benign renal tumors – 14 (8,86%) with angiomyolipoma and 11 (6,96%) with oncocytoma; 53 patients with renal cysts including 15 (9,49%) patients with cystic RCC. The control group amounted to 15 healthy volunteers with normal clinical and radiologic findings.
Results. In the result of measurement and analysis of the ADC dur ing the DWI MRI we achieved statistically significant difference (р-310 –3 mm2/s), solid RCC (1,65±0,38-310 –3 mm2/), benign renal tumors (2,23±0,18-310 –3 mm2/) and renal cysts (3,15±0,51-310–3 mm2/). Also statistically significant difference (р-310 –3 mm2/vs 3,36±0,35-310–3 mm2/accordingly. Nerveless, there was no statistic difference in mean ADC values between of histologic subtypes of RCC (р>0,05).
Conclusions. ADC of DWI MRI can be used as imaging biomarker of RCC and as and effective tool for the differential diagnostics of the malignant and benign SRM.
##plugins.themes.bootstrap3.article.details##
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright and grant the journal the first publication of original scientific articles under the Creative Commons Attribution 4.0 International License, which allows others to distribute work with acknowledgment of authorship and first publication in this journal.
References
Howlader N, Noone AM, Krapcho M et al. SEER Cancer Statistics Review 1975–2013 / National Cancer Institute. Bethesda, MD., – 2016.
Федоренко З.П., Михайлович Ю.Й., Гулак Л.О., Рак в Україні, 2014–2015. / Бюл. нац. канцер-реєстру України No 17. – Київ, 2015. – C. 56–57.
Gill IS, Aron M, Gervais DA et al. Clinical practice: small renal mass / N Engl J Med. – 2010, No 362. – P. 624–634.
Phé Véronique, David R. Yates, Raphaеle Renard Penna et al. Is There a Contemporary Role for Percutaneous Needle Biopsy in the Era of Small Renal Masses? / BJU International. – 2012. – No 6 (109). – Р. 867–872.
Stakhovskyi Oleksandr, Stanley A. Yap, Michael Leveridge et al. Small Renal Mass: What the Urologist Needs to Know for Treatment Planning and Assessment of Treatment Results / American Journal of Roentgenology. – 2011. – No 6 (196). – Р. 1267–1273.
Volpe Alessandro, Carlo Terrone, Roberto M. Scarpa. The Current Role of Percutaneous Needle Biopsies of Renal Tumours / Andrologia: Di Ecografia Urologica E Nefrologica. – 2009. – No 2 (81). – Р. 107–112.
Menogue Stuart R., Beverley A. O’Brien, Alexandra L. Brown et al. Percutaneous Core Biopsy of Small Renal Mass Lesions: A Diagnostic Tool to Better Stratify Patients for Surgical Intervention / BJU International. – 2013. – No 4 (111). – Р. 146–151.
Blute Michael, Joel Prince, Eric Bultman et al. Predictors of non diagnostic renal mass biopsy / The Journal of Urology. – 2015. – No 4 (193). – Р. 532–533.
Fananapazir Ghaneh, Ramit Lamba, Brittany Lewis et al. Utility of MRI in the Characterization of Indeterminate Small Renal Lesions Previously Seen on Screening CT Scans of Potential Renal Donor Patients / American Journal of Roentgenology. – 2015. – No 2 (205). – Р. 325–330.
Baliyan V., Das C. J., Sharma S. et al. Diffusion Weighted Imaging in Urinary Tract Lesions / Clinical Radiology. – 2014. – No 8 (69). – Р. 773–782.
Doganay S., Kocakoç E., Ciçekçi M. et al. Ability and Utility of Diffusion Weighted MRI with Different B Values in the Evaluation of Benign and Malignant Renal Lesions / Clinical Radiology. – 2011. – No 5 (66). – Р. 420–425.
Agnello F., Roy C., Bazille G. et al. Small Solid Renal Masses: Characterization by Diffusion Weighted MRI at 3 T / Clinical Radiology. – 2013. – No 6 (68). – Р. 301–308.
Mytsyk Yu., Borys Y., Dutka I. et al. Value of the Diffusion Weighted MRI in the Differential Diagnostics of Malignant and Benign Kidney Neoplasms – Our Clinical Experience / Polish Journal of Radiology. – 2014. – No 79. – Р. 290–295.
Link Richard E., Sam B. Bhayani, Mohammed E. Allaf et al. Exploring the Learning Curve, Pathological Outcomes and Perioperative Morbidity of Laparoscopic Partial Nephrectomy Performed for Renal Mass / The Journal of Urology. – 2005. – No 5 (173). – Р. 1690–1694.
Fujii Y., Saito K., Iimura Y. et al. Incidence of Benign Pathologic Lesions at Nephrectomy for Renal Masses Presumed to Be Stage I Renal Cell Carcinoma in Japanese Patients: Impact of Sex, Age, and Tumor Size / ASCO Meeting Abstracts. – 2011. – No 7 (29). – Р. 374.
Возіанов С.О., Банира О.Б., Строй О.О., Шуляк О.В. Малі ниркові новоутворення: активне спостереження чи хірургічне лікування? / Укр. Мед. Часопис. – 2012. – No 3 (89). – С. 33–41.
