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Abstract #5168

T1 Hyperintense Cystic Renal Masses in Bosniak v.2019: MR Subtraction Imaging for Enhancing Interobserver Agreement and Diagnostic Performance

Huanhuan Kang1,2, Wei Xu1, Haili Liu3, Huiping Guo1, Xueyi Ning1, Zhe Liu4, and Haiyi Wang1
1Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China, 2Chinese PLA Medical School, Beijing, China, 3Radiology, Fourth Medical Center of Chinese PLA General Hospital, Beijing, China, 4Radiology, Daqing Hospital of Traditional Chinese Medicine, Beijing, China

Synopsis

Keywords: Kidney, Analysis/Processing, MR Subtraction Imaging

Motivation: T1 hyperintensity can affect the assessment of cystic renal masses (CRMs), and MR subtraction imaging may be helpful.

Goal(s): To investigate whether MR subtraction imaging can improve interobserver agreement and diagnostic performance in evaluating T1 hyperintense CRMs.

Approach: A single-center retrospective study.

Results: The over interobserver agreement substantially improved with subtraction (weighted κ = 0.62 vs 0.48, P = .004). Higher interobserver agreement (weighted κ = 0.61 vs 0.44, P = .002) and diagnostic performance (sensitivity, 86.7% vs 77.8%, P = .002; specificity, 84.3% vs 74.5%, P = .004; AUC, 0.855 vs 0.761, P = .017) were noted for junior radiologist with subtraction.

Impact: MR subtraction imaging proves to be a valuable adjunct tool in evaluating T1 hyperintense CRMs, particularly for less experienced readers. This may enhance more consistent application of the Bosniak v.2019 and optimize patient clinical decisions.

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