Characterization of clear cell renal cell carcinoma with diffusion kurtosis imaging: correlation between diffusion kurtosis parameters and tumor cellularity. (27th April 2016)

• Record Type: Journal Article
• Authors: Dai, Yongming; Yao, Qiuying; Wu, Guangyu; Wu, Dongmei; Wu, Lianming; Zhu, Li; Xue, Rong; Xu, Jianrong
• Is Part Of: NMR in biomedicine. Volume 29:Number 7(2016:Jul.)
• Page Start: 873
• Page End: 881
• Publication Date: 2016-04-27
• Subjects: MRI -- diffusion kurtosis imaging -- clear cell renal cell carcinoma -- tumor cellularity; Nuclear magnetic resonance -- Periodicals; Magnetic Resonance Spectroscopy -- Periodicals; 574
• DOI: 10.1002/nbm.3535
• Languages: English
• ISSNs: 0952-3480

Abstract

Abstract : The aim of this study was to evaluate the role of diffusion kurtosis imaging (DKI) in the characterization of clear cell renal cell carcinoma (ccRCC) and to correlate DKI parameters with tumor cellularity. Fifty‐nine patients with pathologically diagnosed ccRCCs were evaluated by DKI on a 3‐T scanner. Regions of interest were drawn on the maps of the mean diffusion coefficient (MD) and mean diffusion kurtosis (MK). All ccRCCs were histologically graded according to the Fuhrman classification system. Tumor cellularity was measured by the nuclear‐to‐cytoplasm (N/C) ratio and the number of tumor cell nuclei (NTCN). ccRCCs were classified as grade 1 ( n = 23), grade 2 ( n = 24), grade 3 ( n = 10) and grade 4 ( n = 3). Both MD and MK could readily discriminate between normal renal parenchyma and ccRCCs ( p < 0.001), and receiver operating characteristic (ROC) curve analysis showed that MK exhibited a better performance with an area under the ROC curve of 0.874 and sensitivity/specificity of 68.33%/100% ( p < 0.001). Further, MD and MK were significantly different between grade 1 and grades 3 and 4 ( p = 0.01, p < 0.001) and between grade 2 and grades 3 and 4 ( p = 0.015, p < 0.005), respectively. However, no significant difference was found between grade 1 and grade 2 ( p > 0.05) for both MD and MK. With regard to NTCN, no significant difference was found between any two grades ( p > 0.05), and the N/C ratio changed significantly with grade ( p < 0.01, between any two grades). Negative correlations were found between MK and MD ( r = –0.56, p < 0.001), and between MD and N/C ratio ( r = –0.36, p < 0.005), whereas MK and the N/C ratio were positively correlated ( r = 0.45, p = 0.003). DKI could quantitatively characterize ccRCC with different grades by probing non‐Gaussian diffusion properties related to changes in the tumor microenvironment or tissue complexities in the tumor. Copyright © 2016 John Wiley & Sons, Ltd. Abstract : A cohort of 59 patients with clear cell renal cell carcinoma was evaluated with diffusion kurtosis imaging (DKI). The quantitatively measured DKI‐related parameters, mean diffusion coefficient (MD) and mean diffusion kurtosis (MK), were shown to be relevant to tumor grade and to correlate with tumor cellularity. This is the first study to use DKI for renal disease evaluation.