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] × 10-3 mm2/s vs [1.77 ± 0.41] × 10-3 mm2/s) and D ([0.90±0.34] × 10-3 mm2/s vs [1.36±0.31] × 10-3 mm2/s) values (all P<0.001), whereas obviously higher D* value ([18.06 ± 7.49] × 10-3 mm2/s vs [14.15±4.70] × 10-3 mm2/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 × 10-3 mm2/s (0.804, 78.57% and 81.08%), D = 0.83 × 10-3 mm2/s (0.850, 64.29% and 100.00%), and D* = 20.53 × 10-3 mm2/s (0.647, 32.14% and 100.00%). Both the diffusionand perfusion-related IVIM-DWI parameters may be helpful in differentiating ccRCC from AML.