Pseudocapsule Assessment Improves ccLS for Renal Mass Discrimination on MRI

Modified Clear Cell Likelihood Score (ccLS) with pseudocapsule assessment improved benign vs malignant renal mass discrimination (AUC 77% vs 65.4%) without losing ccRCC identification accuracy (AUC 88.4% vs 86.8%).

• Adding pseudocapsule assessment to the ccLS raised the AUC for distinguishing benign from malignant renal masses from 65.4% to 77%.
• The modification preserved ccRCC identification performance, with AUCs of 88.4% (ccLS) vs 86.8% (m-ccLS).
• T2 signal intensity ratio was the strongest single mpMRI marker, significantly higher in malignant (1.10) vs benign (0.85) masses and in ccRCC (1.16) vs non-ccRCC (0.85).

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