Evaluation of multiparametric MRI findings in distinguishing clear cell renal cell carcinoma and non-clear cell renal cell carcinoma

When a solid mass is detected in the kidney, it is important to take the right approach towards this mass. Renal cell carcinoma is the most common solid lesion among malignant renal masses. Among the renal cell carcinomas, the most common subtype with the worst prognosis is clear cell renal cell carcinoma. In this study, we investigated the utility of Multiparametric MRI (mpMRI) in the distinguishing of clear cell and non-clear cell renal cell carcinoma. Between January 2020 and September 2022, 37 patients who met the study criteria were included in the research. The patients were divided into two groups as ccRCC and nccRCC according to their final pathology. Of the patients, 19 (51.4%) were ccRCC and 18 (48.6%) were nccRCC. On diffusion-weighted images, min ADC values were higher in the ccRCC group (p=0.0001), with a sensitivity of 89.5% and a specificity of 83.3%, the cut-off value was calculated as 0.7645 x 10-3 mm2/sec [AUC: 0.852 (0.071) (95% CI: 0.714-0.991)]. Ktrans, one of the contrast-enhanced perfusion MR parameters, was found to be higher in the ccRCC group than in the nccRCC group (p=0.0001), with a sensitivity of 89.5% and a specificity of 88.9%, the cut-off value was calculated as 0.2855 [AUC:0.90 (0.053) (95% CI:0.797-1,000)]. Ve was found to be higher in the ccRCC group than in the nccRCC group (p=0.002), with a sensitivity of 89.5% and a specificity of 72.2%, the cut-off value was calculated as 0.1655 [AUC: 0.801 (0.078) (95% CI: 0.649- 0.953)]. In conclusion, min ADC, Ktrans, and Ve values are parameters derived from mpMRI findings that can help distinguish ccRCC from other less aggressive RCC subtypes. Key words: Clear cell renal cell carcinoma, DCE-MRI, Multiparametric MRI, RCC