Diffusion-Weighted Magnetic Resonance Imaging Supplemented by Apparent Diffusion Coefficient in Evaluation of Renal Masses

Background: Recent studies have shown that diffusion weighted imaging (DWI) may enable characterization of kidney lesions and in differentiating benign from malignant ones. However, there are only a few reports investigating the utilization of DWI and ADC measure in the differentiation of small solid kidney masses. The aim of this study was to evaluate the role of Diffusion Weighted MR Imaging (DW-MRI) supplemented with ADC measures in characterization of different kidney masses.

Subjects and Methods: This cross-sectional study included thirty (30) cases presented to the Diagnostic Radiology Department in Tanta University Hospitals with signs and symptoms of kidney masses either by clinical or previous radiological examination. The duration of the study was 3-4 years.

Results: There were 13 participants had clear kidney cell carcinoma with mean ADC 1.32 ± 0.15. There were 7 participants had papillary kidney carcinoma with mean apparent diffusion coefficient (ADC) 1.33 ± 0.13. There were 6 participants had oncocytoma with ADC 1.3 ± 0. There were 4 participants had angiomyolipoma with mean ADC 0.76 ± 0.13. As regard Diffusion-weighted imaging (DWI) sequence parameters; the TR/TE was 3150/55.

Conclusion: DWI is a quick process that can be readily included into a standard MRI protocol. When gadolinium contrast agent cannot be provided, DWI is very useful for lesion identification and assessment. Due to the overlap of ADC measures between benign and cancerous lesions, it cannot be utilized as a standalone diagnostic tool and must be evaluated concurrently with conventional MRI for effective characterization of kidney lesions.