Multiphasic contrast-enhanced MRI: single-slice versus volumetric quantification of tumor enhancement for the assessment of renal clear-cell carcinoma fuhrman grade

J Magn Reson Imaging. 2013 May;37(5):1160-7. doi: 10.1002/jmri.23899. Epub 2012 Nov 13.

Abstract

Purpose: To assess the association between clear-cell carcinoma pathology grade at nephrectomy and magnetic resonance imaging (MRI) tumor enhancement.

Materials and methods: The Institutional Review Board approved this retrospective study and waived the informed consent requirement. In all, 32 patients underwent multiphase contrast-enhanced MRI prior to nephrectomy. MRI tumor enhancement was measured using two approaches: 1) the most enhancing portion of the tumor on a single slice and 2) volumetric analysis of enhancement in the entire tumor. Associations between pathological grade, tumor size, and enhancement were evaluated using the Kruskal-Wallis test and generalized logistic regression models.

Results: No significant association between pathology grade and enhancement was found when measurements were made on a single slice. When measured in the entire tumor, significant associations were found between higher pathology grades and lower mean, median, top 10%, top 25%, and top 50% tumor enhancement (P < 0.001-0.002). On multivariate analysis the association between grade and enhancement remained significant (P = 0.041-0.043), but tumor size did not make an additional contribution beyond tumor enhancement alone in differentiating between tumor grades.

Conclusion: There is significant association between tumor grade and enhancement, but only when measured in the entire tumor and not on the most enhancing portion on a single slice.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Carcinoma, Renal Cell / pathology*
  • Contrast Media
  • Female
  • Gadolinium DTPA*
  • Humans
  • Image Enhancement / methods*
  • Image Interpretation, Computer-Assisted / methods*
  • Imaging, Three-Dimensional / methods*
  • Kidney Neoplasms / pathology*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tumor Burden

Substances

  • Contrast Media
  • Gadolinium DTPA