Comparison of utility of tumor size and apparent diffusion coefficient for differentiation of low- and high-grade clear-cell renal cell carcinoma

被引:28
作者
Maruyama, Mitsunari [1 ]
Yoshizako, Takeshi [1 ]
Uchida, Koji [1 ]
Araki, Hisayoshi [1 ]
Tamaki, Yukihisa [1 ]
Ishikawa, Noriyuki [2 ]
Shiina, Hiroaki [3 ]
Kitagaki, Hajime [1 ]
机构
[1] Shimane Univ, Fac Med, Dept Radiol, Matsue, Shimane, Japan
[2] Shimane Univ, Fac Med, Dept Organ Pathol, Matsue, Shimane, Japan
[3] Shimane Univ, Fac Med, Dept Urol, Matsue, Shimane, Japan
关键词
Urinary; MR diffusion/perfusion; kidney; adults; WEIGHTED MRI; ADC MEASUREMENT; NUCLEAR GRADE; FUHRMAN; INTEROBSERVER; INTRAOBSERVER; VARIABILITY; NEPHRECTOMY; SURVIVAL; LESIONS;
D O I
10.1177/0284185114523268
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Background: There is a significant correlation between tumor size and tumor grade for clear-cell renal cell carcinoma (RCC) in pathology. Thus, apparent diffusion coefficient (ADC) of clear-cell RCC might be influenced by tumor size. Purpose: To compare the utility of tumor size and ADC for distinguishing low-grade from high-grade clear-cell RCC. Material and Methods: Forty-nine patients undergoing preoperative magnetic resonance imaging were retrospectively assessed. ADC values were calculated using b-value combinations of 0 and 800 s/mm(2) at 1.5 T. Two radiologists in consensus measured ADC values via small region of interest (ROI) (mean ROI area, 88.8 mm(2); range, 80-108 mm(2)) placement on an area of solid tumor on a single slice. Maximum tumor diameter was measured at the maximum tumor area. A single pathologist reviewed all pathological slides to determine the nuclear grade according to the Fuhrman classification. The utility of ADC, tumor size, and ADC/size ratio for distinguishing low-grade from high-grade tumors was assessed. Receiver-operating characteristic (ROC) analysis and regression analysis of the each index were performed. The correlation between ADC and tumor size was also investigated. Results: The 49 clear-cell RCC included 34 low-grade and 15 high-grade tumors. The differences of ADC, tumor size, and ADC/size ratio between high-grade and low-grade tumors were statistically significant (P < 0.05). The area under the ROC curve of ADC, tumor size, and ADC/size ratio were 0.802, 0.763, and 0.804 respectively. However, using regression analysis, only ADC (P < 0.05) was statistically significant index as independent risk factors for high-grade clear-cell RCC. Moreover, weak significant correlation was observed between tumor size and ADC (R-2 = 0.3865, P < 0.01). Conclusion: There was a weak significant correlation between tumor size and ADC value of clear-cell RCC. Using ROC and regression analysis, ADC was statistically significant index for distinguishing low-grade from high-grade clear-cell RCC more than tumor size and ADC/size ratio.
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页码:250 / 256
页数:7
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