期刊
UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS
卷 37, 期 12, 页码 941-946出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.urolonc.2019.07.023
关键词
Multiparametric Magnetic; Resonance Imaging; Renal Cell Carcinoma; Small Renal Mass; Renal Mass Biopsy; Partial Nephrectomy; Clear Cell Likelihood Score
资金
- NCI NIH HHS [R01 CA154475, P50 CA196516] Funding Source: Medline
Introduction: Detection of small renal masses (SRM) is increasing with the use of cross-sectional imaging, although many incidental lesions have negligible metastatic potential. A method to identify this subtype would aid in risk stratification. A previously reported clear cell likelihood score (ccLS; 1-very unlikely, 2-unlikely, 3-equivocal, 4-likely, and 5-very likely), based on retrospective review of multiparametric magnetic resonance imaging (mpMRI), predicted the likelihood of encountering clear cell renal cell carcinoma (ccRCC) at surgery. Here, we assess the performance of ccLS prospectively assigned for prediction of ccRCC. Methods: Patients with a known renal mass who underwent mpMRI at a single institution between June 2016 and April 2018 were prospectively assigned a ccLS as part of the clinical MRI report. These patients were retrospectively reviewed, and those with a cT1a lesion and available pathological tissue diagnosis (diagnostic biopsy or extirpative surgery) were selected for analysis. Results: In total, 57 patients (mean age 61.7 +/- 14.9 years) with 63 cT1a renal masses were identified. Mean tumor size was 2.7 +/- 0.7 cm. Defining ccLS 4-5 lesions as positive demonstrated an overall accuracy of 84%, sensitivity of 89%, specificity of 79%, positive predictive value of 84%, and negative predictive value of 86%. A ccLS of 1-2 demonstrates an 86% accuracy and 100% sensitivity/positive predictive value of identifying non-ccRCC histology. Conclusions: Utilizing prospectively assigned ccLS, we confirm that mpMRI can reasonably identify ccRCC histology in cT1a renal masses. Standardization of imaging protocols and reporting criteria such as the ccLS can be used to aid in the diagnosis and management of small renal masses. (C) 2019 Elsevier Inc. All rights reserved.
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