Understanding the difference in Diagnostic accuracy of MRI between ccRCC and pRCC :- A meta Analysis

Abstract

AbstractBackgroundRenal cell carcinoma (RCC) comprises cancer originating from the renal epithelium and takes up for >90% of cancers in the kidney. The disease consists of >10 histological and molecular subtypes, of which clear cell RCC (ccRCC) is the most common and is responsible for most cancer-related deaths. In an attempt to ensure an early diagnosis to plan the further course of surgical intervention, pre-operative diagnosis plays an important role. MRI plays a crucial role in the diagnosis of RCC and planning for surgery for presumed RCC, especially for identifying enhanced soft tissue within renal lesions. The purpose of this meta-analysis is to ascertain the accuracy of MRI in diagnosing papillary renal cell carcinoma (pRCC) compared to clear cell carcinoma to reach a definitive diagnosis and thus, help in surgical intervention.MethodsMedical literature was comprehensively searched and reviewed without restrictions to particular study designs, or publication dates using PubMed, Cochrane Library, and Google Scholar databases for all relevant literature. The extraction of necessary data proceeded after specific inclusion and exclusion criteria were applied. In this Meta-Analysis, a total of 5 papers involving 755 lesions were considered for Clear cell carcinoma. A total number of 13 papers regarding 1009 lesions of papillary renal cell carcinoma were considered. wherein two writers independently assessed the caliber of each study as well as the use of the Cochrane tool for bias risk apprehension. The statistical software packages RevMan (Review Manager, version 5.3), SPSS (Statistical Package for the Social Sciences, version 20), and Excel in Stata 14 were used to perform the statistical analyses.ResultsWe calculated the sensitivity and specificity of MRI in diagnosing pRCC and ccRCC in the different papers, For the MRI in ccRCC, The sensitivity is 0.81 with a CI of 95% in a range of 0.77 to 0.86, the mean being 0.049. The Specificity of the MRI is 0.77 with a CI of 95% in a range of 0.68 to 0.86, the mean being 0.091. For the pRCC, The Sensitivity of the MRI in pRCC is 0.66 with a CI of 95% in a range of 0.52 to 0.80; the mean being (0.14). The Specificity of the MRI in pRCC is 0.87 with a CI of 95% in a range of 0.80 to 0.94, the mean being 0.072.ConclusionMagnetic resonance imaging (MRI) offers a thorough evaluation of renal masses that takes in to account both, functional factors and several types of tissue contrast. In light of the above mentioned clinical requirements, these characteristics of MRI have sped up the process of early detection, diagnosis, staging, and evaluation of the aggressiveness and therapeutic r esponse of RCC