Contrast enhanced MRI and Diffusion Weighted Imaging (DWI) in the evaluation of renal cell carcinoma and differentiation of its subtypes

Objective: The prognosis of different histologic subtypes of RCC varies and affects management. Patients with chromophobe or papillary RCC have better prognosis than those with clear cell RCC. The aim of our work was to study the utility of DCE and DWI in the preoperative prediction of renal cell carcinoma subtypes, using histopathology as a gold standard method of diagnosis. Patients and methods: Thirty five patients with 38 renal masses were included in the study. All had DCE MRI studies with DWI sequences, CER and ADC values calculation for normal and diseased renal tissues. Results: The Mean ADC value of normal renal parenchyma was significantly higher than RCC. The CER and ADC values for Clear cell RCC were higher than Papillary and Chromophobe RCC. No statistically significant difference was found between the CER , ADC values for Papillary and Chromophobe RCC. CER , ADC values of clear RCC were higher than non clear RCC. Conclusions: DCE MRI in addition to DWI , ADC appears as a very helpful imaging tool in the differentiation between clear cell and non-clear cell RCCs