Using 1.5 T Diffusion-Weighted Magnetic Resonance Imaging to Classify Small Solid Renal Tumors

Abstract Background: Imaging techniques are essential to predict the origin of renal tumors and suggest a management plan. Objectives: The current research aimed to assess the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in the differentiation among incidentally detected small renal tumors concerning clinical behavior. Materials and Methods: The current research was conducted at the Hilla Teaching Hospital in Babylon, Hillah, Iraq. The study included 25 patients with small-size renal tumors (≤4 cm). Examination of patients was done using a 1.5 T MRI scanner (Achieva, Philips Medical Systems, The Netherlands) using a SENSE body coil. All enrolled patients were subjected to T2-weighted image that is, coronal HASTE (T2WI), axial GRE T1WI (in-phase and out-of-phase), and axial TSE T2WI. Post-contrast T1 axial and DW-MRI and apparent diffusion coefficient (ADC) map for all patients. Results: The average ADC of malignant tumors was higher in a significant manner than that of tumors that are benign, 1.33 ± 0.02 versus 1.07 ± 0.17 × 10 −3 mm/s, respectively ( P < 0.001). A receiver operating characteristic curve test to define the ADC cutoff value that can predict malignant renal tumors in terms of accuracy, sensitivity, and specificity was performed. The under-curve area was 0.878, the sensitivity was 100%, and the specificity was 77.8% for a cutoff value for ADC of >1.1 × 10 ‐3 mm/s. Conclusion: The use of MRI of the DW kind permits high accuracy in differentiating the clinical behavior of small kidney cell tumors and can be used in clinical practice in cases where renal percutaneous biopsy is inconclusive or difficult to perform.