{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:32:22Z","timestamp":1769041942927,"version":"3.49.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271951"],"award-info":[{"award-number":["82271951"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The von Hippel\u2013Lindau (VHL) mutation is an important alteration in clear cell renal cell carcinoma (ccRCC); however, its imaging phenotype remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate whether MRI features can reflect the VHL mutation status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Retrospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3\u2009T\/fast spin echo T2\u2010weighted, spin\u2010echo echo planar diffusion\u2010weighted, gradient recalled echo T1\u2010weighted, gradient recalled echo chemical\u2010shift T1\u2010weighted, and contrast\u2010enhanced gradient recalled echo T1\u2010weighted sequences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>One hundred five patients with ccRCC who underwent preoperative contrast\u2010enhanced MRI and subsequent genomic sequencing: 59 consecutive patients from our institution (38 [64.41%] with VHL mutations) formed a training cohort, and 46 from The Cancer Genome Atlas (TCGA) database (24 [52.17%] with VHL mutations) formed an independent test cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Two radiologists, with 23 and 33\u2009years of experience respectively, jointly evaluated the semantic MRI features of the primary lesion in ccRCCs to propose potential features related to VHL mutations in both cohorts. Three additional readers, with 5, 7, and 10\u2009years of experience respectively, independently reviewed all lesions to assess the interobserver agreement of MRI features. A VHL mutational likelihood score (VHL\u2010MULIS) system was constructed using the training cohort and validated using the independent test cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Fisher's test or chi\u2010square test, <jats:italic>t<\/jats:italic>\u2010test or Mann\u2013Whitney <jats:italic>U<\/jats:italic> test, logistic regression, Cohen's kappa (<jats:italic>\u03ba<\/jats:italic>), area under the receiver operating characteristic curve (AUC). A two\u2010sided <jats:italic>P<\/jats:italic> value &lt;0.05 was considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In both the local and public cohorts, T2\u2010weighted signal intensity and presence of microscopic fat from primary lesions were significantly associated with VHL mutation status. The VHL\u2010MULIS incorporated maximum diameter, T2\u2010weighted signal intensity, and presence of microscopic fat in the training cohort and demonstrated promising diagnostic ability (AUC, 0.82; sensitivity, 0.79; specificity, 0.82) and substantial interobserver agreement (<jats:italic>\u03ba<\/jats:italic>, 0.787) in the test cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>The VHL mutation exhibited a distinct MRI phenotype. Integrating multiple semantic MRI features has potential to reflect the mutation status in patients with ccRCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evidence Level<\/jats:title><jats:p>3<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 2<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.29588","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T09:54:13Z","timestamp":1724838853000},"page":"1981-1994","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clear Cell Renal Cell Carcinoma: Characterizing the Phenotype of Von Hippel\u2013Lindau Mutation Using <scp>MRI<\/scp>"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8755-4257","authenticated-orcid":false,"given":"Xu","family":"Bai","sequence":"first","affiliation":[{"name":"Medical School of Chinese PLA  Beijing China"},{"name":"Department of Radiology, First 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