The Role of Diffusion-Weighted Imaging and Apparent Diffusion Coefficient Maps in Characterization of Solid Renal Lesions

Öz

Objectives: The purpose of this study was to evaluate the added value of Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) in distinguishing between benign from malignant solid renal lesions. Material and Method: A total of forty-seven patients (age range: 33-84, mean: 59.0± 11.3 years, 27 men, 20 women) with solid renal lesions detected on abdominal MR were included in our study group. The ADCs were calculated from DWI data of two different b values (b=600 mm²/s and b=1000 mm²/s). ADC values for both normal renal parenchyma and solid renal lesions were obtained. Subsequently, ROI analysis was performed to identify threshold ADCs. In all cases, the histopathological data were obtained and correlated. Results: The histopathological outcome comprises 13 benign and 34 malignant solid renal lesions. The solid malignant lesions were Renal Cell Carcinoma subtypes (1 chromophobe cell, four papillary cells, 25 clear cells), 2 Transitional Cell carcinomas, one metastasis, 1 Non-Hodgkin lymphoma. The benign solid renal lesions consisted of 2 oncocytomas and 11 angiomyolipomas. The mean ADC value of malignant lesions was 1,33 x 10-3 mm²/s, benign masses for oncocytomas 1,76 x 10-3 mm²/s, and angiolipomas 1,28 x 10-3 mm²/s respectively (p<0.001). The mean ADC value of normal renal parenchyma was 2,22 x 10-3 mm²/s, and the mean ADC value of benign and malignant masses without discrimination was 1.34 x 10-3 mm²/s (p <0.001). Conclusion: ADC values can be a useful parameter to differentiate malignant solid renal lesions in renal masses. Also, significant differences in ADC values among RCC subtypes indicate the availability of ADC in RCC subtype determination.

Anahtar Kelimeler

• renal masses
• magnetic resonance imaging
• diffusion-weighted imaging
• apparent diffusion coefficient

Solid Renal Lezyonların Karakterizasyonunda Difüzyon Ağırlıklı Görüntüleme ve Görünen Difüzyon Katsayısı Haritalarının Rolü

Öz

Amaç: Bu çalışmanın amacı, benign ve malign solid renal lezyonları ayırt etmede Difüzyon Ağırlıklı Görüntüleme (DAG) ve Görünen Difüzyon Katsayısı (ADC) ile değerlendirmektir. Gereç ve Yöntem: Abdomen MR'da solid renal lezyon saptanan toplam 47 hasta (yaş aralığı: 33-84, ort: 59.0 ± 11.3 yıl, 27 erkek, 20 kadın) çalışma grubumuza dahil edildi. ADC'ler, iki farklı b değerinin (b = 600 mm² / s ve b = 1000 mm² / s) DAG verilerinden hesaplanmıştır. Hem normal renal parankim hem de solid renal lezyonlar için ADC değerleri elde edildi. Daha sonra, eşik ADC'lerini belirlemek için ROI analizi gerçekleştirildi. Tüm olguların histopatolojik verileri elde edildi. Bulgular: Histopatolojik olarak 13 benign ve 34 malign solid renal lezyondan malign lezyonlar, Renal Hücreli Karsinom alt tipleri (1 kromofob hücre, dört papiller hücre, 25 berrak hücre), 2 Geçiş Hücreli karsinom, bir metastaz, 1 Non-Hodgkin lenfomadır. İyi huylu solid böbrek lezyonları 2 onkositom ve 11 anjiyomiyolipomdan oluşuyordu. Malign lezyonların ortalama ADC değeri sırasıyla 1,33 x 10-3 mm² / s, onkositomlar için 1,76 x 10-3 mm² / s ve anjiyolipomlar 1,28 x 10-3 mm² / s idi (p< 0,001). Normal renal parankimin ortalama ADC değeri 2,22 x 10-3 mm² / s, benign ve malign kitlelerin ayrım yapılmaksızın ortalama ADC değeri 1,34 x 10-3 mm² / s idi (p <0,001). Sonuç: ADC değerleri, solid renal kitlelerde malign-benign lezyonları ayırt etmede faydalı bir parametre olabilir. Ek olarak, RCC alt tipleri arasında ADC değerlerindeki önemli farklılıklar, ADC'nin RCC alt tip belirlemesinde kullanılabilirliğini gösterir.

Anahtar Kelimeler

• böbrek kitleleri
• manyetik rezonans görüntüleme
• difüzyon ağırlıklı görüntüleme
• görünen difüzyon katsayısı

Kaynakça

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