In this prospective, single-center study, we evaluated the use of intravoxel incoherent motion model of diffusion (IVIM-DWI) and high-throughput urine proteomics associated with inflammation for diagnosis and characterization of small renal masses. IVIM-DWI parameters had good to excellent diagnostic performance in identifying clear-cell renal cell carcinomas (ccRCC), as well as in distinguishing between stages of ccRCC. In a subset of patients with IVIM-DWI and proteomics, we observed significant correlations between IVIM and proteomic analytes which had differential expression between ccRCC and non-ccRCC, and are involved in promoting the recruitment, expansion and activation of innate and adaptive immune cells.
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