title: Multiphasic contrast-enhanced MRI: single-slice versus volumetric quantification of tumor enhancement for the assessment of renal clear-cell carcinoma fuhrman grade.
abstract: OBJECTIVE
  To assess the association between clear-cell carcinoma pathology grade at nephrectomy and magnetic resonance imaging (MRI) tumor enhancement.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. vargasah@mskcc.org
authors.forename: Hebert Alberto
authors.initials: HA
authors.lastname: Vargas
authors.forename: Holly G
authors.initials: HG
authors.lastname: Delaney
authors.forename: Eithne M
authors.initials: EM
authors.lastname: Delappe
authors.forename: Ya
authors.initials: Y
authors.lastname: Wang
authors.forename: Junting
authors.initials: J
authors.lastname: Zheng
authors.forename: Chaya S
authors.initials: CS
authors.lastname: Moskowitz
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Tan
authors.forename: Binsheng
authors.initials: B
authors.lastname: Zhao
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Schwartz
authors.forename: Hedvig
authors.initials: H
authors.lastname: Hricak
authors.forename: Paul
authors.initials: P
authors.lastname: Russo
authors.forename: Oguz
authors.initials: O
authors.lastname: Akin
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007680:Kidney Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D047368:Tumor Burden
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA