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Exophytic Renal Masses: Angular Interface with Renal Parenchyma for Distinguishing Benign from Malignant Lesions at MR Imaging
- Source :
- Radiology. 255:501-507
- Publication Year :
- 2010
- Publisher :
- Radiological Society of North America (RSNA), 2010.
-
Abstract
- To retrospectively determine whether benign exophytic renal masses can be distinguished from renal cell carcinoma (RCC) on the basis of angular interface at single-shot fast spin-echo (SE) T2-weighted magnetic resonance (MR) imaging.This retrospective study was compliant with HIPAA and was approved by the institutional review board. Patient informed consent was waived. A total of 162 exophytic (2 cm or greater) renal masses in 152 patients (103 men, 49 women; mean age, 58 years; age range, 23-85 years) were included. Two radiologists independently recorded the mass size and angular interface on single-shot fast SE T2-weighted MR images. Surgical pathologic report and MR follow-up were used as reference standards. Logistic regression analysis was used to examine the usefulness of these variables for differentiating benign masses from RCCs. Diagnostic performance was analyzed by comparing values for area under receiver operating characteristic curve (A(z)). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of angular interface for diagnosing benign masses were calculated. Reader agreement was assessed with kappa-weighted statistics and intraclass correlation coefficients (ICCs).Of 162 masses, 65 were benign, and 97 were RCCs. The sensitivity, specificity, PPV, NPV, and A(z) of angular interface for diagnosing benign masses were 78%, 100%, 100%, 87%, and 0.813, respectively. Angular interface (P.001) was a significant predictor of benign renal mass but mass size (P = .66) was not. There was almost perfect interobserver agreement for mass size (ICC = 0.96) and angular interface (kappa = 0.91).The presence of an angular interface with the renal parenchyma at single-shot fast SE T2-weighted MR imaging is a strong predictor of benignity in an exophytic renal mass 2 cm or greater in diameter with high specificity and diagnostic accuracy.
- Subjects :
- Adult
Gadolinium DTPA
Male
medicine.medical_specialty
Pathology
Renal parenchyma
Contrast Media
urologic and male genital diseases
Sensitivity and Specificity
Diagnosis, Differential
Predictive Value of Tests
medicine
Carcinoma
Humans
Radiology, Nuclear Medicine and imaging
Carcinoma, Renal Cell
Aged
Retrospective Studies
Aged, 80 and over
medicine.diagnostic_test
business.industry
Benignity
Magnetic resonance imaging
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Mr imaging
Kidney Neoplasms
Logistic Models
ROC Curve
Female
Kidney Diseases
Radiology
Differential diagnosis
business
Kidney cancer
Kidney disease
Subjects
Details
- ISSN :
- 15271315 and 00338419
- Volume :
- 255
- Database :
- OpenAIRE
- Journal :
- Radiology
- Accession number :
- edsair.doi.dedup.....765d28908e9bf608cc5240bd5171cb8a