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Research Article

Cancer Research Frontiers. 2015 Apr; 1(2): 178-190. doi: 10.17980/2015.178

Detection and differentiation of paediatric renal tumours using diffusion-weighted imaging: an explorative retrospective study.

Isabel Platzer1, Mengxia Li2, Beate Winkler3, Philipp Schweinfurth4, Thomas Pabst1, Thorsten Bley1, Henning Neubauer1[*]

1Department of Diagnostic and Interventional Radiology; 2Department of Radiation Oncology; 3Department of Paediatrics; 4Department of Urology; University Hospital Wuerzburg, 97080 Wuerzburg, Germany.

 
[*] Corresponding author: Henning Neubauer, MD, MBA. Department of Radiology, University Hospital Wuerzburg, Oberduerrbacher Str. 6, 97080 Wuerzburg, Germany. Phone: 0049-931-201-34715. Email: neubauer_h@ukw.de; inu75@web.de

Citation: Isabel Platzer, et al. Detection and differentiation of paediatric renal tumours using diffusion-weighted imaging: an explorative retrospective study. Cancer Research Frontiers. 2015 Apr; 1(2): 178-190. doi: 10.17980/2015.178

Copyright: @ 2015 Isabel Platzer, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Competing Interests: The authors declare that they have no competing interests.

Received January 29, 2015; Revised April 28, 2015; Accepted May 2, 2015.

 

 

Abstract

Background: Diffusion-weighted imaging (DWI) is a promising supplemental technique in oncological magnetic resonance imaging (MRI). We investigated the diagnostic utility of DWI for detection and characterisation of paediatric renal tumours.

Patients and Methods: Eleven consecutive patients (median 4 years, range 4 days to 15 years, females n=9) with histologically proven renal tumours (nephroblastoma n=6, nephroblastomatosis n=2, connatal nephroblastic nephroma n=1, renal cell carcinoma n=1, local recurrence of nephroblastoma n=1) underwent routine clinical MRI at 1.5 Tesla using a standardised oncological scan including free-breathing DWI. We retrospectively analysed lesion detectability and conspicuity of tumour vs. adjacent tissue on DWI and ce-T1w.

Results: All tumour manifestations were detectable on DWI by high signal at high b-values. Mean ADC values ranged between 0.56 to 0.95 with a wide overlap between malignant lesions and nephroblastomatosis. Mean SI ratios were significantly higher on DWI, compared to ce-T1w (4.5±3.8 vs. 1.6±0.7, p<0.001). Six small foci of nephroblastomatosis were occult on ce-T1w imaging, but clearly delineated on DWI. One small bone metastasis was seen on DWI only. In two patients with stable unilateral manifestations of nephroblastomatosis, follow-up MRI showed mean ADC values of 1.0 ± 0.3 over three years.

Conclusion: According to our preliminary experience, DWI reliably detects paediatric renal tumours and metastases. Apparently, DWI cannot distinguish between malignant and non-malignant paediatric renal tumour entities based on mean ADC, but yields superior lesion conspicuity. DWI in free-breathing technique without the need of i.v. contrast application deserves further evaluation as stand-alone imaging, especially for follow-up in young patients.

Keywords: MRI; diffusion-weighted; renal tumour; paediatric

 

 

 

 

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