Application of diffusion-weighted intravoxel incoherent motion imaging in diagnosis of renal cell carcinoma subtypes
10.3760/cma.j.issn.0253-3766.2016.06.007
- VernacularTitle:体素内不相干运动扩散加权成像在肾细胞癌诊断中的应用
- Author:
Xinying CONG
1
;
Yan CHEN
;
Jin ZHANG
;
Xiaoduo YU
;
Feng YE
;
Weijun YU
;
Miaomiao ZHANG
;
Han OUYANG
;
Xinming ZHAO
Author Information
1. 100021,国家癌症中心 北京协和医学院中国医学科学院肿瘤医院影像诊断科
- Keywords:
Kidney neoplasms;
Magnetic resonance imaging;
Diagnosis;
Diagnosis,differential
- From:
Chinese Journal of Oncology
2016;38(6):434-439
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of parameters derived from intravoxel incoherent motion diffusion?weighted magnetic resonance imaging in differentiating histopathological subtypes of renal cell carcinoma ( RCC) . Methods Between May 2014 and December 2015, a total of 69 patients who were surgically and pathologically diagnosed as renal cell carcinoma were recruited for the study. We examined 61 clear cell RCC ( ccRCC) , and 8 non?clear cell carcinoma ( non?ccRCC, including 7 chromophobe RCC and 1 papillary RCC ) . All the ccRCC were divided into well differentiated group ( n = 46 ) , moderately differentiated group (n=8), and poorly differentiated group (n=7). In addition to routine renal magnetic resonance imaging examination performed on a 3. 0?Tesla MR system, all patients were imaged with axial intravoxel incoherent motion diffusion?weighted imaging. Using biexponential model, we calculated the diffusion coefficient ( D) , pseudodiffusion coefficient ( D?) , and perfusion fraction ( f) . Results The D and f values of the ccRCC were higher (each P<0.05) than that for non?ccRCC [D (1.29±0.30)×10-3mm2/s, D?(42.92±20.21)×10-3mm2/s, and f (35.71±6.61)% versus D (0.78±0.23)×10-3mm2/s, D?(32.60±11.33)×10-3mm2/s, and f (21.52±8.44)% ]. In the well differentiated group of ccRCC, we found D of (1.36±0.29)×10-3mm2/s, D?(38.39±18.51)×10-3mm2/s, and f (36.40±6.96)%. The D, D?, f values of moderately differentiated lesions were (1.10±0.24)×10-3mm2/s, (59.90±20.23)×10-3 mm2/s, and (32.88±4.02)%, respectively, those of the poorly differentiated group were (1.03±0.16)×10-3mm2/s, (53.28±18.74)×10-3mm2/s, and (34.42±6.21)%. The well differentiated group of ccRCC showed a higher D value than the moderately differentiated and poorly differentiated groups ( each P<0.05) . D? values were significantly lower for the well differentiated group than for the moderately differentiated group (P<0.05). The sensitivity and specificity of D values were 90. 2% and 87. 5% when focusing on the differentiation of ccRCC. For the diagnosis of ccRCC, the sensitivity and specificity of f values were 98. 4% and 75. 0%, respectively. Conclusions IVIM?DWI can provide certain reliable value in evaluating pathological subtype and differentiation degree of renal cell carcinomas. D and f values are useful to distinguish ccRCC from non?ccRCC. D value is also promising for estimating the differentiation degree of ccRCC, and to indicate the biological behavior of RCC.
