Discrimination of oncocytoma and chromophobe renal cell carcinoma using MRI

Diagn Interv Radiol. 2019 Jan;25(1):5-13. doi: 10.5152/dir.2018.18013.

Abstract

Purpose: We aimed to evaluate magnetic resonance imaging (MRI) features, including signal intensities, enhancement patterns and T2 signal intensity ratios to differentiate oncocytoma from chromophobe renal cell carcinoma (RCC).

Methods: This retrospective study included 17 patients with oncocytoma and 33 patients with chromophobe RCC who underwent dynamic MRI. Two radiologists independently reviewed images blinded to pathology. Morphologic characteristics, T1 and T2 signal intensities were reviewed. T2 signal intensities, wash-in, wash-out values, T2 signal intensity ratios were calculated. Sensitivity and specificity analyses were performed.

Results: Mean ages of patients with oncocytoma and chromophobe RCC were 61.0±11.6 and 58.5±14.0 years, respectively. Mean tumor size was 60.6±47.3 mm for oncocytoma, 61.7±45.9 mm for chromophobe RCC. Qualitative imaging findings in conventional MRI have no distinctive feature in discrimination of two tumors. Regarding signal intensity ratios, oncocytomas were higher than chromophobe RCCs. Renal oncocytomas showed higher signal intensity ratios and wash-in values than chromophobe RCCs in all phases. Fast spin-echo T2 signal intensities were higher in oncocytomas than chromophobe RCCs.

Conclusion: Signal intensity ratios, fast spin-echo T2 signal intensities and wash-in values constitute diagnostic parameters for discriminating between oncoytomas and chromophobes. In the excretory phase of dynamic enhanced images, oncocytomas have higher signal intensity ratio than chromophobe RCC and high wash-in values strongly imply a diagnosis of renal oncocytoma.

Publication types

  • Multicenter Study

MeSH terms

  • Adenoma, Oxyphilic / diagnostic imaging*
  • Adenoma, Oxyphilic / pathology
  • Adult
  • Aged
  • Carcinoma, Renal Cell / diagnostic imaging*
  • Carcinoma, Renal Cell / pathology
  • Diagnosis, Differential
  • Female
  • Humans
  • Image Enhancement / instrumentation
  • Kidney Neoplasms / diagnostic imaging*
  • Kidney Neoplasms / pathology
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sensitivity and Specificity

Supplementary concepts

  • Oncocytoma, renal