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CER Cutoff For Differentiating Clear From Non Clear Rc Case Study

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this study. The CER cutoff for differentiating Clear from Non Clear RCC sub- types was >0.4751 with a sensitivity and specificity of 100% in the cortical phase and >0.8012 with a sensitivity of 95.8% and specificity of 100% in the nephrographic phase. Yamamoto et al. [14] reported a cutoff value of 0.4 with a sensitivity of 92.1% and specificity of 85.7% in the cortical phase and 0.8 with a sensitivity of 96.8% and specificity of 57.1% in the nephrographic phase. There is agreement in the cutoff values in this paper with that of Yamamoto et al. [14] however the differences in the sensitivity and specificity in the nephrographic phase may be attributed to the difference in the patient population between the studies. The results of this …show more content…

In this study, clear cell RCCs demonstrated higher ADCs than papillary RCCs and chromophobic RCCs with a statistically significant difference between the ADC values for the three subtypes (p = 0.0011 and p = 0.0304 respectively). A threshold value of 1.309 _ 10_3 mm2/s permitted distinction between clear cell and non-clear cell RCCs with a sensitivity of 79.17% and specificity of 78.57% were calculated based on ROC analysis. These results are in agreement with those reported by Wang et al. [27] that clear cell and non-clear cell RCCs have different diffusion characteristics that can be distinguished with a threshold value of 1.281 _ 10_3 mm2/s permitted this distinction with a sensitivity of 95.9% and a specificity of 94.4% when b values of 0 and 800 s/mm2 are used to calculate the ADC. Although in their study they used a 3.0 T MRI, similar results were seen when using a 1.5 T machine. Several authors have reported that there was no significant difference found in ADC values when using a 3.0 or 1.5 T machine during assessment of patients with breast cancer [28] and in splenic and pancreatic lesions [29]. In a previous study by Paudyal et al. [30], they reported a significantly lower ADC value in clear-cell RCC compared to non-clearcell RCC in a cohort of 47 patients with papillary carcinoma and chromophobic

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