title: Intratumoral Macroscopic Fat and Hemorrhage Combination Useful in the Differentiation of Benign and Malignant Solid Renal Masses.
abstract: To evaluate the value of combining the detection of intratumoral macroscopic fat and hemorrhage in the differentiation of the benign from malignant solid renal masses.Conventional magnetic resonance imaging (MRI), chemical shift (CS)-MRI, and susceptibility-weighted imaging were performed in 152 patients with 152 solid renal masses, including 48 benign and 104 malignant masses all pathologically confirmed. The presence of macroscopic fat detected by CS-MRI and hemorrhage detected by susceptibility-weighted imaging were evaluated in all masses. The rates of macroscopic fat and hemorrhage observed between benign and malignant masses were compared by a χ test. All masses found to contain macroscopic fat with or without hemorrhage were considered to be benign. The remaining masses (without macroscopic fat) found not to contain hemorrhage were considered to be benign. Only those found to contain hemorrhage alone were considered to be malignant. The evaluation indexes for differentiating and forecasting the benign and malignant masses were calculated.Significant differences in the rate of macroscopic fat (observed in 85.42% of benign masses vs. 0% of malignant masses) and hemorrhage (observed in 4.17% of benign masses vs. 95.19% of malignant masses) were measured in the benign and malignant groups (P < 0.005, for both). The 41 masses containing macroscopic fat with or without hemorrhage and 11 masses containing neither macroscopic fat nor hemorrhage were considered to be benign. The 100 masses containing no macroscopic fat and only hemorrhage were considered to be malignant. By combining the results for the macroscopic fat and hemorrhage, the accuracy, sensitivity, and specificity in the differential diagnosis of the benign and malignant masses were 96.05%, 95.19%, and 97.92%, respectively, and the accuracy and error rate of forecasting the benign and malignant masses were 95.39% and 4.61%, respectively.Combining the detection intratumoral macroscopic fat and hemorrhage can be used to differentiate the benign from malignant solid renal masses.
authors.affiliation: From the Department of Radiology (JS, WX, JC); Department of Urology (ZX, MF); Department of Pathology (TC), Affiliated Third Hospital of Suzhou University, Changzhou, Jiangsu, China; Department of Radiology (LZ, ZZ), Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Radiology (LZ), Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China; and Robert H. Lurie Comprehensive Cancer Center (ZZ), Northwestern University Chicago, Chicago, IL.
authors.forename: Jun
authors.initials: J
authors.lastname: Sun
authors.forename: Zhaoyu
authors.initials: Z
authors.lastname: Xing
authors.forename: Wei
authors.initials: W
authors.lastname: Xing
authors.forename: Linfeng
authors.initials: L
authors.lastname: Zheng
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Min
authors.initials: M
authors.lastname: Fan
authors.forename: Tongbing
authors.initials: T
authors.lastname: Chen
authors.forename: Zhuoli
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006470:Hemorrhage; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007680:Kidney Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies