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25.09.2023 | Kidneys, Ureters, Bladder, Retroperitoneum

Differentiation between renal epithelioid angiomyolipoma and clear cell renal cell carcinoma using clear cell likelihood score

verfasst von: Yu-Wei Hao, Yun Zhang, Hui-Ping Guo, Wei Xu, Xu Bai, Jian Zhao, Xiao-Hui Ding, Sheng Gao, Meng-Qiu Cui, Bai-Chuan Liu, Hui-Yi Ye, Hai-Yi Wang

Erschienen in: Abdominal Radiology | Ausgabe 12/2023

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Abstract

Purpose

Clear cell likelihood score (ccLS) may be a reliable diagnostic method for distinguishing renal epithelioid angiomyolipoma (EAML) and clear cell renal cell carcinoma (ccRCC). In this study, we aim to explore the value of ccLS in differentiating EAML from ccRCC.

Methods

We performed a retrospective analysis in which 27 EAML patients and 60 ccRCC patients underwent preoperative magnetic resonance imaging (MRI) at our institution. Two radiologists trained in the ccLS algorithm scored independently and the consistency of their interpretation was evaluated. The difference of the ccLS score was compared between EAML and ccRCC in the whole study cohort and two subgroups [small renal masses (SRM; ≤ 4 cm) and large renal masses (LRM; > 4 cm)].

Results

In total, 87 patients (59 men, 28 women; mean age, 55±11 years) with 90 renal masses (EAML: ccRCC = 1: 2) were identified. The interobserver agreement of two radiologists for the ccLS system to differentiate EAML from ccRCC was good (k = 0.71). The ccLS score in the EAML group and the ccRCC group ranged from 1 to 5 (73.3% in scores 1–2) and 2 to 5 (76.7% in scores 4–5), respectively, with statistically significant differences (P < 0.001). With the threshold value of 2, ccLS can distinguish EAML from ccRCC with the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 87.8%, 95.0%, 73.3%, 87.7%, and 88.0%, respectively. The AUC (area under the curve) was 0.913. And the distribution of the ccLS score between the two diseases was not affected by tumor size (P = 0.780).

Conclusion

The ccLS can distinguish EAML from ccRCC with high accuracy and efficiency.

Graphical Abstract

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Titel: Differentiation between renal epithelioid angiomyolipoma and clear cell renal cell carcinoma using clear cell likelihood score
verfasst von: Yu-Wei Hao
Yun Zhang
Hui-Ping Guo
Wei Xu
Xu Bai
Jian Zhao
Xiao-Hui Ding
Sheng Gao
Meng-Qiu Cui
Bai-Chuan Liu
Hui-Yi Ye
Hai-Yi Wang
Publikationsdatum: 25.09.2023
Verlag: Springer US
Erschienen in: Abdominal Radiology / Ausgabe 12/2023
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-023-04034-5

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Differentiation between renal epithelioid angiomyolipoma and clear cell renal cell carcinoma using clear cell likelihood score