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The utility of diffusion-weighted imaging in differentiation of papillary and clear cell subtypes of renal cell carcinoma
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Original Article
VOLUME: 48 ISSUE: 1
P: 8-14
2015

The utility of diffusion-weighted imaging in differentiation of papillary and clear cell subtypes of renal cell carcinoma

Acta Haematol Oncol Turc 2015;48(1):8-14
DOI: 10.5505/aot.2015.25238
Hale Çolakoğlu Er
Elif Peker
Ayşe Erden
Erdem Öztürk
1. Department Of Radiology, Şehitkamil State Hospital, Gaziantep
2. Department Of Radiology, Ankara University, Ankara, Turkey
3. Department Of Urology, Ankara University, Ankara, Turkey
4.
No information available.
No information available
Received Date: 2014-12-22T23:43:13
Accepted Date: 2015-06-18T09:50:39
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Abstract

OBJECTIVE

To determine the utility of diffusion-weighted imaging (DWI) in differentiation of papillary and clear cell subtypes of renal cell carcinoma (RCC).

METHODS

A total of 16 patients with papillary RCC and clear cell RCC were enrolled in this retrospective study. Patients underwent MRI with a 3.0-Tesla wholebody system (MAGNETOM Verio, Siemens, Erlangen, Germany) using a standard body matrix coil. Apparent diffusion coefficient (ADC) values and signal intensity (SI) values at b=50 s/mm2 b=1000 s/mm2 DWI of solid components of the renal masses and SI values of normal renal parenchyma were measured. A freehand ROI was drawn around the peripheral margin of the tumor on the diffusion images excluding the cystic or necrotic portions, while referring to the T2-weighted conventional images for verification of lesion boundaries. To measure SI values of normal renal parenchyma, ROIs were placed on the normal corticomedullary junction.

RESULTS

Mean ADC value was statistically significantly lower in papillary RCC (0.991 ± 0.143×10ˉ³ mm²/s) than in that of clear cell RCC (1.296 ±.0.277 × 10ˉ³ mm²/s). For the papillary RCC group, there was statistically significant difference (p<0.05) between mean SI values of normal parenchyma (22.8 ± 6.3) and lesion (43.4± 14.8) at b=1000 s/mm2 DWI; for the clear cell RCC group there was statistically significant difference (p<0.05) between mean SI value of normal parenchyma (138.8 ± 33) and lesion (102± 27.5) at b=50 s/mm2 DWI.

CONCLUSION

For discrimination of papillary and clear cell subtypes of RCC, DWI seems to be a useful method. The boundaries of papillary RCC can be more clearly perceived on b=1000 s/mm2 and that of clear cell RCC on b=50 s/mm2 DWI. However, more extensive research on a larger series of patients are needed to support our findings.