title: Is Multiparametric MRI Useful for Differentiating Oncocytomas From Chromophobe Renal Cell Carcinomas?
abstract: OBJECTIVE
  The purpose of this study was to retrospectively evaluate the diagnostic accuracy of multiparametric MRI to differentiate oncocytoma from chromophobe renal cell carcinoma (RCC).
  
  
  METHODS
  In this retrospective study, 26 histologically confirmed oncocytomas and 16 chromophobe RCCs that underwent full MRI examination were identified in 42 patients (25 men and 17 women) over a 6-year period. Demographic data were recorded. Double-echo chemical-shift, dynamic contrast-enhanced T1- and T2-weighted images, and apparent diffusion coefficient (ADC) maps were reviewed independently by two radiologists blinded to pathologic results. Signal-intensity index (SII), tumor-to-spleen signal-intensity ratio, ADC ratio, three wash-in indexes, and two washout indexes were calculated and compared using univariate and ROC analyses. Sensitivity and specificity analyses were performed to calculate diagnostic accuracy.
  
  
  RESULTS
  All carcinomas and nine oncocytomas were resected; the remaining 17 oncocytomas were biopsied. Patient age (for oncocytomas: mean, 68.2 years; range, 43-84 years; for RCCs: mean, 60.8 years; range, 20-79 years) and tumor size (for oncocytomas: mean, 35.5 mm; range, 12-98 mm; for RCCs: mean, 37.2 mm; range, 9-101 mm) did not differ significantly across groups (p = 0.132 and 0.265, respectively). Good interobserver agreement was observed for all measurements but four. Oncocytomas presented significantly higher ADC (p = 0.002) and faster enhancement (p = 0.007-0.012) but lower SII (p = 0.03) than carcinomas. This combination provided sensitivity of 92.3% (24/26), specificity of 93.8% (15/16), and accuracy of 92.9% (39/42) for the detection of oncocytomas.
  
  
  CONCLUSIONS
  Multiparametric MRI helps to accurately differentiate oncocytomas from chromophobe RCCs with high sensitivity and specificity.
authors.affiliation: 1 Department of Radiology, Pellegrin Hospital, Pl Amélie Raba Léon, 33076 Bordeaux, France.
authors.forename: Chloe
authors.initials: C
authors.lastname: Galmiche
authors.affiliation: 2 Department of Urology, Pellegrin Hospital, Bordeaux, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Bernhard
authors.affiliation: 3 Department of Pathology, Pellegrin Hospital, Bordeaux, France.
authors.forename: Mokrane
authors.initials: M
authors.lastname: Yacoub
authors.affiliation: 4 Department of Oncology, Saint-André Hospital, Bordeaux, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Ravaud
authors.affiliation: 1 Department of Radiology, Pellegrin Hospital, Pl Amélie Raba Léon, 33076 Bordeaux, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Grenier
authors.affiliation: 1 Department of Radiology, Pellegrin Hospital, Pl Amélie Raba Léon, 33076 Bordeaux, France.
authors.forename: François
authors.initials: F
authors.lastname: Cornelis
mesh_terms: D018249:Adenoma, Oxyphilic / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: DWI; MRI; oncocytomas; renal cell carcinomas; renal neoplasms