• Gurcan Erbay, Zafer Koc, Elif Karadeli, Baris Kuzgunbay, M Resit Goren, and Nebil Bal.
• Faculty of Medicine, Department of Radiology, Baskent University, Ankara, Turkey.
• Acta Radiol. 2012 Apr 1; 53 (3): 359-65.

BackgroundLimited data are available regarding the use of diffusion-weighted (DW) magnetic resonance imaging (MRI) with multiple b values for characterization of renal lesions.PurposeTo demonstrate and compare the diagnostic performance of DW-MRI with multiple b values for renal lesion characterization.Material And MethodsSixty-three lesions (36 malignant, 27 benign) in 60 consecutive patients (48 men, 12 women; age 60 ± 12.5 years) with solid/cystic renal lesion diagnosed after MRI were included prospectively. Single-shot echo-planar DW abdominal MRI (1.5T) was obtained using seven b values with eight apparent diffusion coefficient (ADC) maps. Contrast-to-noise ratios (CNRs), signal intensities, lesion ADCs, and lesion/normal parenchyma ADC ratios were analyzed. Receiver-operating characteristic analysis was performed.ResultsThe mean signal intensities of malignant lesions (at b0, 50, and 200s/mm(2)) were significantly lower than those of benign lesions (P < 0.05). The mean ADC values at all b value combinations of malignant lesions were significantly lower than those of benign lesions (P < 0.000), excluding the ADC value at b50 s/mm(2). ADC with all b values could better distinguish between benign and malignant lesions. A 1.35 × 10(-3) mm(2)/s threshold ADC value permitted this distinction with 85.2% sensitivity and 65.6% specificity. The lesion/normal parenchyma ADC ratio was more effective than the lesion ADC.ConclusionIn addition to the ADC value, the signal intensity curve on DW images using multiple b values could be helpful for differentiation of malignant and benign renal lesions.

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