Bosniak IIF and III Renal Cysts: Can Apparent Diffusion Coefficient–Derived Texture Features Discriminate Between Malignant and Benign IIF and III Cysts?

Objective The aim of this study was to determine which apparent diffusion coefficient–derived texture features are associated with malignancy in Bosniak IIF and III renal cystic lesions. Methods Twenty benign and 7 malignant Bosniak IIF (22) or III (5) renal cysts, as evaluated with magnetic resonance imaging, were assessed for progression to pathology-confirmed malignancy. Whole-cyst volumes of interest were manually segmented from apparent diffusion coefficient maps. Texture features were extracted from each volume of interest, including first-order histogram-based features and higher-order features, and data were analyzed with the Mann-Whitney U test to predict malignant progression. Results Eleven of 17 first-order features were significantly greater in benign compared with malignant cysts. Eight higher-order gray-level co-occurrence matrix (GLCM) texture features were significantly different between groups, 5 of which were greater in the benign population. Conclusions Apparent diffusion coefficient–derived texture measures may help differentiate between benign and malignant Bosniak IIF and III cysts. Received for publication November 18, 2018; accepted January 7, 2019. Correspondence to: Nicolas Gillingham, BA, 660 First Avenue, Third Floor, New York, NY 10016 (e-mail: Nicolas.Gillingham@nyulangone.org). OCRID ID: 0000-0003-3346-2044. This study was not grant funded. The authors declare no conflict of interest. Institutional review board approval was obtained for this study, and all procedures performed were in accordance with the Helsinki Declaration of 1964 and later versions. The requirement for individual informed consent for this study was waived. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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