Grading of Clear Cell Renal Cell Carcinoma by Using Monoexponential, Biexponential, and Stretched Exponential Diffusion-weighted MR Imaging

Overview

Journal Front Oncol

Specialty Oncology

Date 2024 Nov 15

PMID 39544290

Authors

Wenhui Wang

Lingdian Wang

Jing Zhou

Taiyuan Liu

Yan Bai

Meiyun Wang

Affiliations

Soon will be listed here.

Abstract

Objectives: To evaluate the diagnostic accuracy of monoexponential, biexponential and stretched-exponential diffusion-weighted imaging (DWI) models in the grading of clear cell renal cell carcinoma (ccRCC).

Materials And Methods: Fifty-one patients with pathologically proven ccRCC underwent DWI with fifteen factors (0, 10, 30, 50, 70, 100, 150, 200, 300, 400, 600, 800, 1000, 1500, 2000 sec/mm²) on a 3.0T MR scanner. The isotropic apparent diffusion coefficient (ADC), true diffusion coefficient (ADC), pseudodiffusion coefficient (ADC), and fraction of perfusion (f) were derived from DWI using a biexponential model. The water diffusion heterogeneity index (α) and distributed diffusion coefficient (DDC) were derived from DWI using a stretched-exponential model. All values were calculated for the solid area of tumors and compared between high-grade and low-grade ccRCC. The Mann-Whitney U test and receiver operating characteristic (ROC) analysis were used for statistical analysis. The DeLong test was performed to compare the ROC curves.

Results: The mean ADC, DDC, ADC and α values were significantly lower in high-grade ccRCC than in low-grade ccRCC (P< 0.01). However, the ADC and f were not significantly different between the two groups (P > 0.05). According to the ROC analyses, the AUC for α was 0.941, which was significantly greater than those of the other parameters, with a sensitivity of 100% and a specificity of 84.2%. The DeLong test showed that there were significant differences in the ROCs among ADC/ADC, ADC/α, f/ADC, ADC/ADC, f/α, DDC/α, and f/ADC.

Conclusions: Diffusion-related parameters (ADC, DDC, ADC and α) could be used to distinguish between low- and high-grade ccRCC. The α derived from the stretched-exponential model may be the most promising parameter for grading ccRCC.

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