Renal cell carcinoma: role of MR imaging in the assessment of muscular venous branch invasion.
Radiology
; 267(2): 454-9, 2013 May.
Article
in En
| MEDLINE
| ID: mdl-23418001
ABSTRACT
PURPOSE:
To assess diagnostic performance and interreader agreement of tumor-to-sinus distance measurements and visual assessment of renal sinus fat invasion at T2-weighted magnetic resonance (MR) imaging as predictors of muscular venous branch invasion (MVBI) in patients with renal cell carcinoma (RCC). MATERIALS ANDMETHODS:
The institutional review board approved this retrospective study and waived the informed consent requirement. The study was HIPAA compliant. A total of 186 consecutive patients underwent preoperative 1.5-T MR imaging; 188 RCCs were identified. Blinded to histopathologic information, two readers independently measured the tumor-to-sinus distance and assessed renal sinus fat invasion on transverse and coronal T2-weighted MR images. Interreader agreement (intraclass correlation coefficient, Cohen κ) and performance characteristics of imaging tests were calculated. Histopathologic findings served as the standard of reference.RESULTS:
Histopathologic findings indicated MVBI in 35% (66 of 188) of tumors. At imaging, all tumors with MVBI had a tumor-to-sinus distance of 0 mm. All tumors with renal sinus fat invasion at imaging had MVBI. Sensitivity and specificity for the detection of renal sinus fat invasion were 100% (95% confidence interval [CI] 92%, 100%) and 94% (95% CI 89%, 98%). In the absence of renal sinus fat invasion at imaging, a tumor-to-sinus distance of 0 mm was associated with MVBI in 21% (18 of 86) of cases. Interreader agreement for quantitative (intraclass correlation coefficient = 0.92; 95% CI 0.89, 0.94) and qualitative (κ = 0.89; 95% CI 0.81, 0.96) assessments was excellent.CONCLUSION:
Tumor-to-sinus distance measurements and the assessment of renal sinus fat invasion at T2-weighted MR imaging can be used reliably to rule out MVBI in patients with RCC.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Magnetic Resonance Imaging
/
Carcinoma, Renal Cell
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Kidney Neoplasms
/
Neoplasm Invasiveness
Type of study:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Qualitative_research
/
Risk_factors_studies
Limits:
Female
/
Humans
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Male
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Middle aged
Language:
En
Journal:
Radiology
Year:
2013
Type:
Article
Affiliation country:
United States