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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Genitourinary Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1564485
Differential diagnosis of Clear Cell Renal Cell Carcinoma with low signal intensity on T2WI from Angiomyolipoma without visible fat on MR imaging
Provisionally accepted- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
To determine the potential of magnetic resonance imaging (MRI) parameters in differentiating angiomyolipoma without visible fat (AML.wovf) from clear cell renal cell carcinoma (ccRCC) with low signal intensity on T2-weighted imaging (T2WI).This was a retrospective study involving 36 cases of ccRCC and 17 cases of AML.wovf from September 2016 to July 2023. All patients underwent histological examination on resected specimens and contrast-enhanced magnetic resonance imaging (CE-MRI). Clinical characteristics, such as age, gender, and symptoms of hematuria and lumbago were recorded. A panel of MRI parameters were analyzed, including tumor growth patterns, wedge-shaped sign, pseudocapsule formation, arterial-to-delayed enhancement ratio (ADER) and apparent diffusion coefficient (ADC). The potential of MRI parameters in distinguishing ccRCC from AML.wovf was finally determined, and visualized in a nomogram.There were no significant differences in age, gender, and clinical symptoms between ccRCC and AML.wovf groups. The wedge-shaped sign was more prevalent in AML.wovf patients (p=0.027), while pseudocapsule formation was mainly observed in cases of ccRCC (p<0.001). Quantitative MRI revealed a significantly lower ADC in AML.wovf patients (p=0.007). Pseudocapsule formation (OR 140.29, p=0.004), wedge-shaped sign (OR 0.05, p=0.047), and ADC (OR 36.22, p=0.037) were independent predictors for differentiating AML.wovf from ccRCC, and their combination demonstrated the highest diagnostic accuracy, with an area under the curve (AUC) of 0.913 in the receiver operating characteristic (ROC) analysis.A combination of MRI parameters, including wedge-shaped sign, pseudocapsule formation, and ADC, can accurately differentiate AML.wovf from ccRCC.
Keywords: AML.wovf, ccRCC, MRI, wedge-shaped sign, pseudocapsule formation, ADC
Received: 21 Jan 2025; Accepted: 07 Mar 2025.
Copyright: © 2025 Chen, Zhang, Ren, Cao, Lan, Xia, Wang and Qiu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhong-Qiu Wang, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
Wenli Qiu, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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