Highlights
- •Algorithms perform similarly to trained subspecialists in diagnosing T2 iso- and hypointense renal mass.
- •Higher inter-reader agreement with algorithm utilization likely due to use of quantitative MR parameters
- •Substantial diagnosis-limiting overlap in the MR appearance of T2 iso- and hypointense renal masses
Abstract
Purpose
To assess if a templated algorithm can improve the diagnostic performance of MRI for
characterization of T2 isointense and hypointense renal masses.
Methods
In this retrospective study, 60 renal masses with histopathologic diagnoses that were
also confirmed as T2 iso- or hypointense on MRI were identified (mean ± standard deviation,
range: 3.9 ± 2.5, 1.0–13.7 cm). Two semi-quantitative diagnostic algorithms were created
based on MRI features of renal masses reported in the literature. Three body-MRI trained
radiologists provided clinical diagnoses based on their experience and separately
provided semiquantitative data for each components of the two algorithms. The algorithms
were applied separately by a radiology trainee without additional interpretive input.
Logistic regression was used to compare the accuracy of the three methods in distinguishing
malignant versus benign lesions and in diagnosing the exact histopathology. Inter-reader
agreement for each method was calculated using Fleiss' kappa statistics.
Results
The accuracy of the two algorithms and clinical experience were similar (70%, 69%,
and 64%, respectively, p = 0.22–0.32), with fair to moderate inter-reader agreement (Fleiss's kappa: r = 0.375, r = 0.308, r = 0.375, respectively, all p < 0.0001). The accuracy of the two algorithms and clinical experience in diagnosing
specific histopathology were also no different from each other (34%, 29%, and 32%,
respectively, p = 0.49–0.74), with fair to moderate inter-reader agreement (Fleiss's kappa: r = 0.20, r = 0.28, r = 0.375, respectively, all p < 0.0001).
Conclusion
Semi-quantitative templated algorithms based on MRI features of renal masses did not
improve the ability to diagnose T2 iso- and hypointense renal masses when compared
to unassisted interpretation by body MR trained subspecialists.
Keywords
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Article info
Publication history
Published online: November 05, 2020
Accepted:
October 29,
2020
Received in revised form:
October 3,
2020
Received:
August 26,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
