{"title":"透明细胞可能性评分结合囊性变性或坏死在MR影像上鉴别cT1实性肾肿块中透明细胞肾细胞癌的诊断价值。","authors":"Xueyi Ning, Mengqiu Cui, Huiping Guo, Honghao Xu, Yuanhao Ma, Xu Bai, Shaopeng Zhou, Xiaohui Ding, Xiaojing Zhang, Huiyi Ye, Haiyi Wang","doi":"10.1186/s13244-025-02029-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic value of the clear cell likelihood score (ccLS) integrated with cystic degeneration or necrosis on renal MR imaging for diagnosing clear cell renal cell carcinoma (ccRCC) in cT1 solid renal masses (SRMs).</p><p><strong>Methods: </strong>This retrospective study consecutively enrolled patients with pathologically confirmed SRMs who underwent MRI at the First Medical Center of the Chinese PLA General Hospital between January 2022 and February 2024. Three radiologists independently scored all cT1 SRMs using ccLS and ccLS integrated with cystic degeneration or necrosis (cn-ccLS), with discrepancies reconciled by consensus. Sensitivity, specificity, and accuracy were used to assess the performance of ccLS and cn-ccLS.</p><p><strong>Results: </strong>A total of 287 patients with 293 masses were included in this study. The sample comprised 229 ccRCCs (78%), 64 other tumors. The sensitivity of cn-ccLS was significantly higher than ccLS (92% vs 74%; p < 0.001), with equal specificity to ccLS (88% vs 91%; p > 0.05). For cT1a and cT1b SRMs, the sensitivity of cn-ccLS was significantly higher than ccLS (cT1a: 90% vs 74%, p < 0.05; cT1b: 98% vs 75%, p < 0.001).</p><p><strong>Conclusions: </strong>Incorporating cystic degeneration or necrosis into the ccLS system significantly enhances the diagnostic performance of the ccLS system for ccRCC in cT1 SRMs. However, future validation of the ccLS system through large-sample, multi-center, and prospective studies is still required.</p><p><strong>Critical relevance statement: </strong>Incorporating cystic degeneration or necrosis into the ccLS system enhances performance for ccRCC in cT1 SRMs. It may enhance the value of ccLS and assist radiologists in their daily diagnostic work.</p><p><strong>Key points: </strong>The cn-ccLS effectively reduced the proportion of ccRCC among ccLS 3 lesions. cn-ccLS better diagnosed ccRCC for cT1a or cT1b renal masses than ccLS. ccRCC sensitivity was improved, but the impact on non-ccRCC remains unevaluated.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"149"},"PeriodicalIF":4.5000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229434/pdf/","citationCount":"0","resultStr":"{\"title\":\"Diagnostic performance of the clear cell likelihood score integrated with cystic degeneration or necrosis on MR imaging for identifying clear cell renal cell carcinoma in cT1 solid renal masses.\",\"authors\":\"Xueyi Ning, Mengqiu Cui, Huiping Guo, Honghao Xu, Yuanhao Ma, Xu Bai, Shaopeng Zhou, Xiaohui Ding, Xiaojing Zhang, Huiyi Ye, Haiyi Wang\",\"doi\":\"10.1186/s13244-025-02029-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To evaluate the diagnostic value of the clear cell likelihood score (ccLS) integrated with cystic degeneration or necrosis on renal MR imaging for diagnosing clear cell renal cell carcinoma (ccRCC) in cT1 solid renal masses (SRMs).</p><p><strong>Methods: </strong>This retrospective study consecutively enrolled patients with pathologically confirmed SRMs who underwent MRI at the First Medical Center of the Chinese PLA General Hospital between January 2022 and February 2024. Three radiologists independently scored all cT1 SRMs using ccLS and ccLS integrated with cystic degeneration or necrosis (cn-ccLS), with discrepancies reconciled by consensus. Sensitivity, specificity, and accuracy were used to assess the performance of ccLS and cn-ccLS.</p><p><strong>Results: </strong>A total of 287 patients with 293 masses were included in this study. The sample comprised 229 ccRCCs (78%), 64 other tumors. The sensitivity of cn-ccLS was significantly higher than ccLS (92% vs 74%; p < 0.001), with equal specificity to ccLS (88% vs 91%; p > 0.05). For cT1a and cT1b SRMs, the sensitivity of cn-ccLS was significantly higher than ccLS (cT1a: 90% vs 74%, p < 0.05; cT1b: 98% vs 75%, p < 0.001).</p><p><strong>Conclusions: </strong>Incorporating cystic degeneration or necrosis into the ccLS system significantly enhances the diagnostic performance of the ccLS system for ccRCC in cT1 SRMs. However, future validation of the ccLS system through large-sample, multi-center, and prospective studies is still required.</p><p><strong>Critical relevance statement: </strong>Incorporating cystic degeneration or necrosis into the ccLS system enhances performance for ccRCC in cT1 SRMs. It may enhance the value of ccLS and assist radiologists in their daily diagnostic work.</p><p><strong>Key points: </strong>The cn-ccLS effectively reduced the proportion of ccRCC among ccLS 3 lesions. cn-ccLS better diagnosed ccRCC for cT1a or cT1b renal masses than ccLS. ccRCC sensitivity was improved, but the impact on non-ccRCC remains unevaluated.</p>\",\"PeriodicalId\":13639,\"journal\":{\"name\":\"Insights into Imaging\",\"volume\":\"16 1\",\"pages\":\"149\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229434/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Insights into Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13244-025-02029-y\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Insights into Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13244-025-02029-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
目的：探讨肾MR透明细胞可能性评分（ccLS）联合囊性变性或坏死对cT1实性肾肿块（SRMs）透明细胞肾细胞癌（ccRCC）的诊断价值。方法：本回顾性研究连续招募了2022年1月至2024年2月在中国人民解放军总医院第一医学中心接受MRI检查的病理证实的SRMs患者。三名放射科医生分别使用ccLS和ccLS合并囊性变性或坏死（cn-ccLS）对所有cT1 SRMs进行独立评分，差异经协商一致。敏感性、特异性和准确性用于评估ccLS和cn-ccLS的性能。结果：共纳入287例患者293例肿块。样本包括229个ccrcc(78%)， 64个其他肿瘤。cn-ccLS的敏感性显著高于ccLS (92% vs 74%；p 0.05)。对于cT1a和cT1b SRMs， cn-ccLS的敏感性显著高于ccLS （cT1a: 90% vs 74%）。结论：将囊性变性或坏死纳入ccLS系统可显著提高ccLS系统对cT1 SRMs ccRCC的诊断效能。然而，未来仍需要通过大样本、多中心和前瞻性研究来验证ccLS系统。关键相关性声明：将囊性变性或坏死纳入ccLS系统可提高ccRCC在cT1 SRMs中的疗效。它可以提高ccLS的价值，并协助放射科医生进行日常诊断工作。重点：cn-ccLS有效降低了ccls3病变中ccRCC的比例。cn-ccLS对cT1a或cT1b肾肿块的诊断优于ccLS。ccRCC的敏感性有所提高，但对非ccRCC的影响仍未评估。
Diagnostic performance of the clear cell likelihood score integrated with cystic degeneration or necrosis on MR imaging for identifying clear cell renal cell carcinoma in cT1 solid renal masses.
Objectives: To evaluate the diagnostic value of the clear cell likelihood score (ccLS) integrated with cystic degeneration or necrosis on renal MR imaging for diagnosing clear cell renal cell carcinoma (ccRCC) in cT1 solid renal masses (SRMs).
Methods: This retrospective study consecutively enrolled patients with pathologically confirmed SRMs who underwent MRI at the First Medical Center of the Chinese PLA General Hospital between January 2022 and February 2024. Three radiologists independently scored all cT1 SRMs using ccLS and ccLS integrated with cystic degeneration or necrosis (cn-ccLS), with discrepancies reconciled by consensus. Sensitivity, specificity, and accuracy were used to assess the performance of ccLS and cn-ccLS.
Results: A total of 287 patients with 293 masses were included in this study. The sample comprised 229 ccRCCs (78%), 64 other tumors. The sensitivity of cn-ccLS was significantly higher than ccLS (92% vs 74%; p < 0.001), with equal specificity to ccLS (88% vs 91%; p > 0.05). For cT1a and cT1b SRMs, the sensitivity of cn-ccLS was significantly higher than ccLS (cT1a: 90% vs 74%, p < 0.05; cT1b: 98% vs 75%, p < 0.001).
Conclusions: Incorporating cystic degeneration or necrosis into the ccLS system significantly enhances the diagnostic performance of the ccLS system for ccRCC in cT1 SRMs. However, future validation of the ccLS system through large-sample, multi-center, and prospective studies is still required.
Critical relevance statement: Incorporating cystic degeneration or necrosis into the ccLS system enhances performance for ccRCC in cT1 SRMs. It may enhance the value of ccLS and assist radiologists in their daily diagnostic work.
Key points: The cn-ccLS effectively reduced the proportion of ccRCC among ccLS 3 lesions. cn-ccLS better diagnosed ccRCC for cT1a or cT1b renal masses than ccLS. ccRCC sensitivity was improved, but the impact on non-ccRCC remains unevaluated.
期刊介绍：
Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere!
I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe.
Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy.
A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field.
I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly.
The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members.
The journal went open access in 2012, which means that all articles published since then are freely available online.
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