Are growth patterns on MRI in small (< 4 cm) solid renal masses useful for predicting benign histology?

European Radiology
Robert S LimNicola Schieda

Abstract

To evaluate previously described growth patterns in < 4 cm solid renal masses. With IRB approval, 63 renal cell carcinomas (RCC; clear cell n = 22, papillary n = 28, chromophobe n = 13) and 36 benign masses [minimal-fat (mf) angiomyolipoma (AML) n = 13, oncocytoma n = 23) from a single institution were independently evaluated by two blinded radiologists (R1/R2) using T2-weighted MRI for (1) the angular interface sign (AIS), (2) bubble-over sign (BOS), (3) percentage (%) exophytic growth and (4) long-to-short axis ratio. Comparisons were performed using ANOVA, chi-square and multi-variate regression. AIS was present in 11.1% (7/63) -9.5% (6/63) R1/R2 RCC compared to 13.9% (5/36) -19.4% (7/36) R1/R2 benign masses (p = 0.68 and 0.16). BOS was present in 11.1% (7/63) -3.2% (2/63) R1/R2 RCC compared to 16.7% (6/36) -8.3% (3/36) R1/R2 benign masses (p = 0.432 and 0.261). Agreement was moderate (K = 0.50 and 0.55). mf-AML [66 ± 32% (range 0-100%)] and oncocytoma [53 ± 26% (0-90%)] had larger % exophytic growth compared to RCC [32 ± 23% (0-80%)] (p < 0.001). No RCC had 90-100% exophytic growth, present in 38.5% (5/13) mf-AMLs and 17.4% (4/23) oncocytomas. The long-to-short axis did not differ between groups (p = 0.053). Benign masses s...Continue Reading

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Citations

Apr 9, 2019·Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes·Fatma KulaliYasar Bukte
Jul 2, 2020·World Journal of Clinical Cases·Xiao-Long LiYing-Wei Wang
Mar 28, 2019·AJR. American Journal of Roentgenology·Christopher S LimStuart G Silverman
Nov 6, 2020·Abdominal Radiology·Mitchell P WilsonGavin Low

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