Utility Of Intravoxel Incoherent Motion Diffusion-Weighted Imaging In Differentiating Renal Cell Carcinoma From Angiomyolipoma

We discussed the utility of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for discriminating clear cell renal cell carcinoma (ccRCC) from angiomyolipoma (AML). Preoperative IVIM-DWI parameter (ADC, D, D and f) values were compared between the ccRCC (n = 37) and AML (n = 28) groups. AML exhibited significantly lower ADC ([1.35+/-0.29] x 10(-3) mm(2)/s vs [1.77 +/- 0.41] x 10(-3) mm(2)/s) and D ([0.90+/-0.34] x 10(-3) mm(2)/s vs [1.36+/-0.31] x 10(-3) mm(2)/s) values (all P<0.001), whereas obviously higher D* value ([18.06 +/- 7.49] x 10(-3) mm(2)/s vs [14.15+/-4.70] x 10(-3) mm(2)/s) (P<0.05) than ccRCC. Optimal cut-off values (area under the curve, sensitivity and specificity) for distinguishing ccRCC from AML were as follows: ADC = 1.54 x 10(-3) mm(2)/s (0.804, 78.57% and 81.08%), D = 0.83 x 10(-3) mm(2)/s (0.850, 64.29% and 100.00%), and D* = 20.53 x 10(-3) mm(2)/s (0.647, 32.14% and 100.00%). Both the diffusion-and perfusion-related IVIM-DWI parameters may be helpful in differentiating ccRCC from AML.