Journal article
Diagnostic performance of prospectively assigned clear cell Likelihood scores (ccLS) in small renal masses at multiparametric magnetic resonance imaging
Urologic oncology, Vol.37(12), pp.941-946
12/2019
DOI: 10.1016/j.urolonc.2019.07.023
PMCID: PMC6934987
PMID: 31540830
Abstract
•The imaging based clear cell likelihood score predicts the likelihood of encounter clear cell renal cell carcinoma on final pathology for renal lesions.•This score has demonstrated an overall accuracy of 84%, sensitivity of 89%, specificity of 79%, positive predictive value of 84%, and negative predictive value of 86%.•A low likelihood score confers a 100% sensitivity and positive predictive value of identifying nonclear cell histology.•Multiparametric magnetic resonance imaging provides information that may negate the need for biopsy.
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.
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.
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.
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.
Details
- Title: Subtitle
- Diagnostic performance of prospectively assigned clear cell Likelihood scores (ccLS) in small renal masses at multiparametric magnetic resonance imaging
- Creators
- Brett A. Johnson - Department of Urology, University of Texas Southwestern, Dallas, TXSandy Kim - The University of Texas Southwestern Medical CenterRyan L. Steinberg - The University of Texas Southwestern Medical CenterAlberto Diaz de Leon - The University of Texas Southwestern Medical CenterIvan Pedrosa - The University of Texas Southwestern Medical CenterJeffrey A. Cadeddu - The University of Texas Southwestern Medical Center
- Resource Type
- Journal article
- Publication Details
- Urologic oncology, Vol.37(12), pp.941-946
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.urolonc.2019.07.023
- PMID
- 31540830
- PMCID
- PMC6934987
- ISSN
- 1078-1439
- eISSN
- 1873-2496
- Language
- English
- Date published
- 12/2019
- Academic Unit
- Urology
- Record Identifier
- 9984319977202771
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