Diffusion-weighted imaging using 3.0 T MRI as a possible biomarker of renal tumors.
Diffusion-weighted imaging using 3.0 T MRI as a possible biomarker of renal tumors.
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发表时间：
2015-04
影响因子：
2
通讯作者：
H. Mírka;E. Korčáková;J. Kastner;M. Hora;O. Hes;P. Hošek;J. Ferda
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作者：
H. Mírka;E. Korčáková;J. Kastner;M. Hora;O. Hes;P. Hošek;J. Ferda
背景/目的弥散加权成像（DWI）可以区分良性和恶性肿瘤，组织学肿瘤类型及其分级。本研究的目的是评估DWI使用3特斯拉磁共振成像（3T MRI）在术前评估肾脏肿瘤的能力。患者和方法本回顾性研究纳入139例患者中的143个肿瘤（130例恶性肿瘤和13例良性肿瘤），采用b值分别为50、400和800 s/mm的DWI检查(2)。在所有肿瘤中，测量实体组织中表观扩散系数（ADC）的最低值，并与组织学表现相关。结果良性肿瘤与恶性肿瘤adc差异有统计学意义（p<0.001）。最常见的恶性肿瘤与良性肿瘤的比较，透明细胞肾癌（CCRCC） I级与嗜瘤细胞瘤有明显的重叠，存在显著的交界性差异（p=0.046）。通过评估恶性肿瘤的组织学类型，我们发现CCRCC与所有其他组织学类型之间存在显著差异(憎色性（CH） RCC p=0.048，乳头状（p) RCC p=0.002，尿路上皮癌（UC） p=0.002）。其他类型的癌不能相互分化（所有病例p=1.0）。低级别（I+II级）和高级别（III+IV级）CCRCC差异有统计学意义（p<0.001）。即使在CCRCC I级和其他级别之间也存在显著差异（II级p=0.01， III+IV级p<0.001）。结论DWI可能有助于鉴别CCRCC与其他组织学类型，并确定其分级。该方法具有一定的鉴别良恶性肿瘤的潜力；然而，最常见的CCRCC I级和嗜瘤细胞瘤的鉴别仍然很困难。
BACKGROUND/AIM Diffusion-weighted imaging (DWI) allows for differentiation of benign from malignant tumors, histological tumor types and their grade. The aim of the study was to evaluate the capabilities of DWI using 3 Tesla Magnetic resonance imaging (3T MRI) in the preoperative assessment of renal tumors. PATIENTS AND METHODS This retrospective study included 143 tumors in 139 patients (130 malignant tumors and 13 benign tumors) that were examined using DWI with b values of 50, 400 and 800 s/mm(2). In all tumors, the lowest value of apparent diffusion coefficient (ADC) in the solid tissue was measured and correlated with the histological finding. RESULTS A significant difference between ADCs of malignant and benign tumors was found (p<0.001). Comparison of the most common malignant and benign tumors clear-cell renal carcinoma (CCRCC) grade I and oncocytoma resulted in a difference of borderline significance with a marked overlap (p=0.046). By assessing the histological types of malignant tumors, we detected a significant difference between CCRCC and all other histological types (p=0.048 for chromophobe (CH) RCC, p=0.002 for papillary (P) RCC and p=0.002 for urothelial carcinoma (UC)). Mutual differentiation of other types of carcinomas was not feasible (p=1.0 in all cases). The differences between low-grade (grade I+II) and high-grade (grade III+IV) CCRCC was significant (p<0.001). A significant difference was found even between CCRCC grade I and others (p=0.01 for grade II, p<0.001 for grade III+IV, respectively). CONCLUSION DWI may contribute in distinguishing CCRCC from other histological types and to determinits grade. The method has certain potential for distinguishing benign from malignant tumors; however, differentiation of the most frequently represented types, CCRCC grade I and oncocytoma, remains difficult.