Role of intravoxel incoherent motion diffusion-weighted MRI in differentiation of renal cell carcinoma subtypes

Abstract

Renal cell carcinoma is the most fatal form of renal tumors, representing about ninety percent of all renal cancers. There are different variations in prognosis among various histological types of RCC. In recent years, there has been a greater emphasis on differentiating between RCC subtypes. Evaluation of different subtypes of renal cell carcinoma using intravoxel incoherent motion (IVIM) diffusion-weighted MRI is the aim of this study. Clear cell renal cell carcinoma (CCRCCs) showed highest f and D values, followed by chromophobe renal cell carcinoma (ChRCCs), while papillary renal cell carcinoma (PRCCs) had the lowest values. CCRCCs had significantly different D and f values compared to non-clear types (PRCC and ChRCC) (P < 0.05). The D* values of CCRCC were the highest, PCRCC had intermediate values, while ChRCCs had the lowest values (P < 0.05). The D* values of ChRCCs demonstrated significant difference when compared to both CCRCCs and PRCCs (P < 0.05). The cutoff points of D, D* and f parameters for distinguishing CCRCCs from non-clear cell types (ChRCCs and PRCC) were 0.835, 0.0355 and 0.335, respectively, yielding specificities of 97.2%, 83.3% and 76.5% and sensitivities of 100%, 57.5% and 72.7%, respectively. Intravoxel incoherent motion (IVIM) can be utilized to distinguish renal cell carcinoma subtypes.