Diagnostic value of a model combining contrast-enhanced ultrasound, computed tomography, and magnetic resonance imaging parameters for microvascular invasion in renal cell carcinoma

Abstract

Objectives: To evaluate the diagnostic value of combined contrast-enhanced ultrasound (CEUS), computed tomography (CT), and magnetic resonance imaging (MRI) parameters for detecting microvascular invasion (MVI) in renal cell carcinoma (RCC). Methods: From January 2024 to December 2025, the clinical records of RCC patients treated in a hospital in East China were retrospectively collected. Among them, 52 patients with MVI were included in the MVI group. Using propensity score matching (ratio 1:1), 52 patients without MVI were included in the non-MVI group. All patients underwent CEUS, CT, and MRI examinations. The differences in examination parameters between the two groups were compared. The diagnostic value of those parameters for RCC-MVI was analyzed. Results: Compared with the non-MVI group, the MVI group had shorter time to peak, initial enhancement time, and washout time, higher kurtosis, entropy, maximum apparent diffusion coefficient (ADCmax), and minimum ADC (ADCmin), and lower energy parameters (all P < 0.001). ROC curve analysis showed that the AUC values of time to peak, initial enhancement time, washout time, kurtosis, energy, entropy, ADCmax, and ADCmin for diagnosing RCC-MVI were 0.791, 0.856, 0.874, 0.789, 0.873, 0.898, 0.855, and 0.884, respectively, with sensitivities of 82.69%, 80.77%, 73.08%, 71.15%, 78.85%, 86.54%, 86.54%, and 86.54%, respectively. The AUC of the combined strategy was 0.966. Conclusion: The combination of CEUS, CT, and MRI parameters showed promising preliminary performance for identifying MVI in RCC. Further internal and external validation is required before the model can be considered for clinical application.