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Aim of the study <p>To evaluate the diagnostic performance of the Clear Cell Likelihood Score (ccLS) in characterizing indeterminate small renal masses (SRMs) in patients undergoing percutaneous biopsy.</p> Materials and methods <p>Sixty consecutive patients who underwent MRI and percutaneous renal mass biopsy for SRMs at our institution between 2013 and 2023 were identified. Three radiologists retrospectively reviewed the MRI exams and assigned ccLS scores, blinded to the final histopathology. The diagnostic accuracy of ccLS for the diagnosis of clear cell renal cell carcinoma (ccRCC) and papillary RCC (pRCC) was evaluated, and interobserver agreement was assessed.</p> Results <p>A total of 60 SRMs in 60 patients were evaluated. At histopathologic analysis 28/60 (47%) were ccRCC, 15/60 (25%) pRCC, 11/60 (18%) oncocytomas, 4/60 (7%) chromophobe RCC and 2/60 (3%) were fat-poor angiomyolipomas. For ccRCC diagnosis, the AUC was 0.86 (95% CI: 0.77–0.95) for reader 1, 0.75 (95% CI: 0.63–0.87) for reader 2, and 0.88 (95% CI: 0.80–0.97) for reader 3, respectively. For pRCC diagnosis, AUC was 0.92 (95% CI: 0.85–0.99) for reader 1, 0.83 (95% CI: 0.73–0.93) for reader 2, and 0.88 (95% CI: 0.80–0.97) for reader 3, respectively. Interreader agreement was substantial for ccLS ≥ 3 (k = 0.60 [95% CI: 0.42–0.78], PA = 85% [95% CI: 78–93]) and ccLS ≥ 4 (k = 0.64 [95% CI: 0.49–0.80], PA = 82% [95% CI: 75–90]) scores.</p> Conclusions <p>ccLS score demonstrates good diagnostic accuracy and reproducibility for characterizing indeterminate SRMs in patients undergoing percutaneous biopsy.</p>

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Diagnostic performance of the clear cell likelihood score (ccLS) for small renal masses characterization in patients undergoing percutaneous biopsy

  • 期刊论文

  • 发表日期：

    2026年2月21日

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  • Giorgio Brembilla,
  • Renato Pennella,
  • Gianluca Siciliano,
  • Tommaso Russo,
  • Antonino Campisi,
  • Michele Cosenza,
  • Giulio Imperiale,
  • Diego Palumbo,
  • Chiara Re,
  • Giuseppe Rosiello,
  • Alessando Larcher,
  • Francesco Montorsi,
  • Umberto Capitanio,
  • Francesco De Cobelli

摘要

Aim of the study

To evaluate the diagnostic performance of the Clear Cell Likelihood Score (ccLS) in characterizing indeterminate small renal masses (SRMs) in patients undergoing percutaneous biopsy.

Materials and methods

Sixty consecutive patients who underwent MRI and percutaneous renal mass biopsy for SRMs at our institution between 2013 and 2023 were identified. Three radiologists retrospectively reviewed the MRI exams and assigned ccLS scores, blinded to the final histopathology. The diagnostic accuracy of ccLS for the diagnosis of clear cell renal cell carcinoma (ccRCC) and papillary RCC (pRCC) was evaluated, and interobserver agreement was assessed.

Results

A total of 60 SRMs in 60 patients were evaluated. At histopathologic analysis 28/60 (47%) were ccRCC, 15/60 (25%) pRCC, 11/60 (18%) oncocytomas, 4/60 (7%) chromophobe RCC and 2/60 (3%) were fat-poor angiomyolipomas. For ccRCC diagnosis, the AUC was 0.86 (95% CI: 0.77–0.95) for reader 1, 0.75 (95% CI: 0.63–0.87) for reader 2, and 0.88 (95% CI: 0.80–0.97) for reader 3, respectively. For pRCC diagnosis, AUC was 0.92 (95% CI: 0.85–0.99) for reader 1, 0.83 (95% CI: 0.73–0.93) for reader 2, and 0.88 (95% CI: 0.80–0.97) for reader 3, respectively. Interreader agreement was substantial for ccLS ≥ 3 (k = 0.60 [95% CI: 0.42–0.78], PA = 85% [95% CI: 78–93]) and ccLS ≥ 4 (k = 0.64 [95% CI: 0.49–0.80], PA = 82% [95% CI: 75–90]) scores.

Conclusions

ccLS score demonstrates good diagnostic accuracy and reproducibility for characterizing indeterminate SRMs in patients undergoing percutaneous biopsy.