News | Magnetic Resonance Imaging (MRI) | July 22, 2021

MRI, Clear Cell Likelihood Score Correlate with Renal Mass Growth Rate

64-Year-Old Man With Clear Cell Likelihood Score (ccLS) 5 Renal Masses

64-Year-Old Man With Clear Cell Likelihood Score (ccLS) 5 Renal Masses. Coronal T2-weighted single shot fast spin echo and coronal T1-weighted fat-saturated spoiled gradient echo acquired during corticomedullary phase—ccLS5 lesion outlined red for clarity.

Axial T1-weighted gradient echo opposed-phase and in-phase images.

Axial T1-weighted gradient echo opposed-phase and in-phase images.

Follow-up coronal T2-weighted single shot fast spin echo at 2.79 years. ccLS5 renal mass heterogeneously hyperintense with intense corticomedullary enhancement, presence of microscopic fat (i.e., drop in signal intensity on opposed-phase compared to in-phase), and significant interval growth (50.4%/year volume growth).

Follow-up coronal T2-weighted single shot fast spin echo at 2.79 years. ccLS5 renal mass heterogeneously hyperintense with intense corticomedullary enhancement, presence of microscopic fat (i.e., drop in signal intensity on opposed-phase compared to in-phase), and significant interval growth (50.4%/year volume growth).

July 22, 2021 — According to ARRS’ American Journal of Roentgenology (AJR), the standardized non-invasive clear cell likelihood score (ccLS) — derived from MRI — correlates with the growth rate of small renal masses (cT1a, ≤4 cm) and may help guide personalized management.

Extracted from clinical reports, “the ccLS scores the likelihood that the small renal mass represents clear cell renal cell carcinoma, from 1 (very unlikely) to 5 (very likely),” explained corresponding author Ivan Pedrosa from the University of Texas Southwestern Medical Center at Dallas. “Small renal masses with lower ccLS may be considered for active surveillance, whereas small renal masses with higher ccLS may warrant earlier intervention.”

Pedrosa and colleagues’ retrospective study included consecutive small renal masses assigned a ccLS on clinical MRI examinations performed between June 2016 and November 2019 at an academic tertiary-care medical center or its affiliated safety net hospital system. Tumor size measurements were extracted from available prior and follow-up cross-sectional imaging examinations, through June 2020.

Among 389 small renal masses in 339 patients (198 men, 141 women; median age, 65 years) on active surveillance that were assigned a ccLS on clinical MRI examinations, those with ccLS4–5 grew significantly faster (9% diameter, 29% volume yearly) than those with ccLS1–2 (5% diameter, p<.001; 16% volume, p<.001) or ccLS3 (4% diameter, p<.001; 15% volume, p<.001).

Noting that the lack of validated imaging markers to characterize biologic aggressiveness of small renal masses hinders medical decision making among available initial management strategies, “growth is associated with ccLS in small renal masses,” the authors of this AJR article reiterated, “with higher ccLS correlating with faster growth.”

For more information: arrs.org

Related Content

SurveyVitals, a leading patient experience analytics provider, announced it has joined forces with the Radiology Business Management Association (RBMA) to launch Postmarks, a real-time patient and partner feedback software solution
News | Patient Engagement | July 22, 2021
July 22, 2021 — SurveyVitals, a leading patient experie
This change will be debuted at HIMSS 2021, and Vital will be exhibiting as Canon Medical for the first time
News | Information Technology | July 22, 2021
July 22, 2021 — Canon Medical Systems Corpora
Registration is now open for the Radiological Society of North America (RSNA) 107th Scientific Assembly and Annual Meeting, the world’s largest annual radiology forum, to be held at McCormick Place Chicago, Nov. 28 – Dec. 2, 2021

Getty Images

News | RSNA | July 21, 2021
July 21, 2021 — Registration is now open for the Radiological Society of North America (...
Artificial intelligence-powered diagnostic tool spots asymptomatic prostate cancer in seconds

(L-R) Associate Professor Peter Brotchie (St Vincent's), Dr Ruwan Tennakoon (RMIT), Professor John Thangarajah (RMIT), Dr Mark Page (St Vincent's). Image courtesy of St Vincent's Hospital Melbourne

News | Prostate Cancer | July 19, 2021
July 19, 2021 — Prostate cancer is the most diagnosed