The Efficiency of Acoustic Radiation Force Impulse (Arfi) Elastography in the Differentiation of Renal Cell Carcinoma and Oncocytoma

Abstract

Purpose This study is to investigate the effectiveness of Acoustic Radiation Force Impulse (ARFI) elastography in differentiating radiologically similar renal cell carcinoma (RCC) and oncocytoma in solid masses of the kidney. Methods The patients with solid renal mass histopathological diagnosed after excision or tru-cat biopsy who underwent a preoperative ARFI elastography of the lesion during a 4-year period were included in this study. Preoperative shear wave velocity (SWV) values were measured in all the lesions. SWV results of RCCs and oncocytomas were compared by an independent t-test, and cut-off, sensitivity and specificity values were calculated. Results Forty-two of the 60 patients included in the study were men (70%) and, 18 were women (30%), and the mean age was 59.7 +/- 14 (27-94) years. Among 46 RCCs (76.6%), 23 and 14 oncocytomas, 5 (23.4%) were located in the right kidney (p:0.34722). Mean SWV values were found to be significantly higher in RCCs (2.87 +/- 0.74 (0.96-4.14) m/s) than oncocytomas (1.83 +/- 0.78 (0.80-3.76) m/s) (p <0.001). In the ROC analysis, a cut-off value of 2.29 m/s was found to havean 80.4% sensitivity and a 78.6% specificity for the discrimination of RCCs from oncocytomas. Conclusion ARFI elastography measurements may be useful in distinguishing RCC and oncocytomas that may have similar solid radiological imaging features.