Document Detail

MR imaging of renal cortical tumours: qualitative and quantitative chemical shift imaging parameters.
MedLine Citation:
PMID:  23300041     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To assess qualitative and quantitative chemical shift MRI parameters of renal cortical tumours.
METHODS: A total of 251 consecutive patients underwent 1.5-T MRI before nephrectomy. Two readers (R1, R2) independently evaluated all tumours visually for a decrease in signal intensity (SI) on opposed- compared with in-phase chemical shift images. In addition, SI was measured on in- and opposed-phase images (SI(IP), SI(OP)) and the chemical shift index was calculated as a measure of percentage SI change. Histopathology served as the standard of reference.
RESULTS: A visual decrease in SI was identified significantly more often in clear cell renal cell carcinoma (RCCs) (R1, 73 %; R2, 64 %) and angiomyolipomas (both, 80 %) than in oncocytomas (29 %, 12 %), papillary (29 %, 17 %) and chromophobe RCCs (13 %, 9 %; all, P < 0.05). Median chemical shift index was significantly greater in clear cell RCC and angiomyolipoma than in the other histological subtypes (both, P < 0.001). Interobserver agreement was fair for visual (kappa, 0.4) and excellent for quantitative analysis (concordance correlation coefficient, 0.80).
CONCLUSIONS: A decrease in SI on opposed-phase chemical shift images is not an identifying feature of clear cell RCCs or angiomyolipomas, but can also be observed in oncocytomas, papillary and chromophobe RCCs. After excluding angiomyolipomas, a decrease in SI of more than 25 % was diagnostic for clear cell RCCs.
KEY POINTS: • Chemical shift MRI offers new information about fat within renal tumours. • Opposed-phase signal decrease can be observed in all renal cortical tumours. • A greater than 25 % decrease in signal appears to be diagnostic for clear cell RCCs.
Christoph A Karlo; Olivio F Donati; Irene A Burger; Junting Zheng; Chaya S Moskowitz; Hedvig Hricak; Oguz Akin
Publication Detail:
Type:  Journal Article     Date:  2013-01-10
Journal Detail:
Title:  European radiology     Volume:  23     ISSN:  1432-1084     ISO Abbreviation:  Eur Radiol     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-17     Completed Date:  2013-12-26     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1738-44     Citation Subset:  IM    
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MeSH Terms
Adenoma, Oxyphilic / diagnosis,  pathology
Aged, 80 and over
Angiomyolipoma / diagnosis,  pathology
Body Mass Index
Carcinoma, Papillary / diagnosis,  pathology
Carcinoma, Renal Cell / diagnosis,  pathology
Kidney / pathology*
Kidney Neoplasms / diagnosis*,  pathology*
Magnetic Resonance Imaging / methods*
Middle Aged
Nephrectomy / methods
Observer Variation
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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