Histogram Analysis of Whole-Lesion Enhancement in Differentiating Clear Cell from Papillary Subtype of Renal Cell Cancer
Histogram Analysis of Whole-Lesion Enhancement in Differentiating Clear Cell from Papillary Subtype of Renal Cell Cancer
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DOI：
10.1148/radiol.12111281
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发表时间：
2012-12-01
期刊：
影响因子：
19.7
通讯作者：
Kiraly, Atilla P.
中科院分区：
文献类型：
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作者：
Chandarana, Hersh;Rosenkrantz, Andrew B.;Kiraly, Atilla P.
目的：比较基于体素的全病变（WL）增强直方图分析与基于定性评估和感兴趣区域（ROI）增强分析在鉴别肾细胞癌（RCC）亚型透明细胞RCC （ccRCC）和乳头状RCC （pRCC）中的应用价值。材料和方法：在这项机构审查委员会批准的、符合hipaa标准的回顾性研究中，73名患者在2007年1月至2010年1月期间接受了RCC术前磁共振（MR）成像。对比剂给药前后获得的三维脂肪抑制t1加权梯度回波皮质髓相图像被转移到工作站，在工作站进行自动登记，然后进行RCC的半自动分割。百分比增强以每体素为基础计算：(SIpost-SIpre)/SIpre。100，其中SIpre和SIpost分别表示增强前后的信号强度。计算每个病变的平均、中位数和第三个四分位数增强的WL定量参数以及直方图分布参数峰度和偏度。将WL增强参数与基于roi的分析和定性评价在区分ccRCC和pRCC的诊断准确性和解读器一致性方面进行了比较。结果：病理检查prcc 19例，ccrcc 55例。与pRCC相比，ccRCC的WL均值、中位数和第三个四分位数增强显著高于pRCC，峰度和偏度显著低于pRCC（均P < 0.001）。第三四分位数增强区分ccRCC和pRCC的准确率最高（94.6%，曲线下面积0.980），显著高于定性评价的准确率（86.0%,P = 0.04），但不显著高于ROI增强的准确率（89.2%,P = 0.52）。与ROI增强和定性评价（kappa分别为0.83和0.7）相比，WL增强参数在区分ccRCC和pRCC方面具有更高的解读者一致性（kappa = 0.91-1.0）。结论：WL增强直方图分析是可行的，可用于鉴别ccRCC和pRCC，准确度较高。(c) rsna, 2012
Purpose: To compare histogram analysis of voxel-based whole-lesion (WL) enhancement to qualitative assessment and region-of-interest (ROI)-based enhancement analysis in discriminating the renal cell cancer (RCC) subtype clear cell RCC (ccRCC) from papillary RCC (pRCC).Materials and Methods: In this institutional review board-approved, HIPAA-compliant retrospective study, 73 patients underwent magnetic resonance (MR) imaging prior to surgery for RCC between January 2007 and January 2010. Three-dimensional fat-suppressed T1-weighted gradient-echo corticomedullary phase acquisitions, obtained before and after contrast agent administration, were transferred to a workstation at which automated registration followed by semiautomated segmentation of the RCC was performed. Percent enhancement was computed on a per-voxel basis: (SIpost-SIpre)/SIpre . 100, where SIpre and SIpost indicate signal intensity before and after contrast enhancement, respectively. The WL quantitative parameters of mean, median, and third quartile enhancement and histogram distribution parameters kurtosis and skewness were computed for each lesion. WL enhancement parameters were compared with ROI-based analysis and qualitative assessment with regards to diagnostic accuracy and interreader agreement in differentiating ccRCC from pRCC.Results: There were 19 pRCCs and 55 ccRCCs at pathologic examination. ccRCC had significantly higher WL mean, median, and third quartile enhancement compared with pRCC and hade significantly lower kurtosis and skewness (all P < .001). Third quartile enhancement had the highest accuracy (94.6%; area under the curve, 0.980) in discriminating ccRCC from pRCC, which was significantly higher than the accuracy of qualitative assessment (86.0%; P = .04) but not significantly higher than that of ROI enhancement (89.2%; P = .52). WL enhancement parameters had higher interreader agreement (kappa = 0.91-1.0) compared with ROI enhancement or qualitative assessment (kappa = 0.83 and 0.7, respectively) in discriminating ccRCC from pRCC.Conclusion: WL enhancement histogram analysis is feasible and can potentially be used to differentiate ccRCC from pRCC with high accuracy. (C) RSNA, 2012