Intra and inter-tumor heterogeneity pose a challenging task for predicting tumor behavior due to the limited understanding of the molecular mechanism of clear cell renal cell carcinoma (ccRCC) development. The purpose of the present study was to correlate non-invasive quantitative measures of heterogeneity on MR imaging with histopathologic signatures of aggressiveness and gene expression heterogeneity in ccRCC. MRI derived Haralick texture features offer objective, quantitative measures of ccRCC aggressiveness, which can help compensate for the limitations of percutaneous biopsies in the tissue characterization of larger, heterogeneous tumors and assist in the implementation of active surveillance and neoadjuvant therapy protocols.
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