Feasibility and Reproducibility of T2 Mapping Compared with Diffusion-Weighted Imaging in Solid Renal Masses

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Renal Pathology

Background:

• Accurate characterization of renal masses, including subtype, WHO/ISUP grade, and pathological T (pT) stage of clear cell renal cell carcinoma (ccRCC), is vital for patient management.
• Current imaging techniques may have limitations in differentiating specific renal mass subtypes and grading ccRCC.

Purpose of the Study:

• To assess the feasibility and reproducibility of motion-robust radial T2 mapping for differentiating lipid-poor angiomyolipoma (MFAML) from RCC.
• To investigate the utility of radial T2 mapping in characterizing the WHO/ISUP grade and pT stage of ccRCC.
• To compare the performance of T2 mapping with diffusion-weighted imaging (DWI) using apparent diffusion coefficient (ADC) values.

Main Methods:

• Ninety-two patients underwent renal radial T2 mapping and ZOOMit DWI.
• T2 values and ADC values were analyzed.
• Correlation coefficients were calculated between ADC and T2 values.

Main Results:

• Clear cell renal cell carcinoma (ccRCC) demonstrated significantly higher T2 and ADC values compared to lipid-poor angiomyolipoma (MFAML) (p < 0.05).
• T2 values were inversely correlated with higher WHO/ISUP grade and pT stage in ccRCC (p < 0.05).
• T2 mapping showed a superior area under the curve (AUC) for evaluating WHO/ISUP grade (0.936) versus ADC (0.817) (p = 0.027).
• T2 values moderately positively correlated with ADC (r = 0.675, p < 0.001).

Conclusions:

• Quantitative motion-robust radial T2 mapping is a feasible technique for characterizing solid renal masses.
• Radial T2 mapping offers added value in multiparametric imaging for predicting WHO/ISUP grade and pT stage of ccRCC.
• This technique may improve diagnostic accuracy and aid in clinical decision-making for renal tumors.