Histogram Analysis of Whole-Lesion Enhancement in Differentiating Clear Cell from Papillary Subtype of Renal Cell Cancer

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Abstract
Histogram analysis of whole-lesion enhancement as well as histogram distribution parameters kurtosis and skewness can be used to discriminate clear cell renal cell cancer (RCC) from papillary RCC with high accuracy and high interreader agreement. PurposeTo compare histogram analysis of voxel-based whole-lesion (WL) enhancement to qualitative assessment and region-of-interest (ROI)-based enhancement analysis in discriminating the renal cell cancer (RCC) subtype clear cell RCC (ccRCC) from papillary RCC (pRCC).Materials and MethodsIn this institutional review board–approved, HIPAA-compliant retrospective study, 73 patients underwent magnetic resonance (MR) imaging prior to surgery for RCC between January 2007 and January 2010. Three-dimensional fat-suppressed T1-weighted gradient-echo corticomedullary phase acquisitions, obtained before and after contrast agent administration, were transferred to a workstation at which automated registration followed by semiautomated segmentation of the RCC was performed. Percent enhancement was computed on a per-voxel basis: (SIpost – SIpre)/SIpre ·100, where SIpre and SIpost indicate signal intensity before and after contrast enhancement, respectively. The WL quantitative parameters of mean, median, and third quar...

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