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Diffusion-weighted imaging using 3.0 T MRI as a possible biomarker of renal tumors

H. Mirka, E. Korcakova, J. Kastner, M. Hora, O. Hes, P. Hosek, J. Ferda,

. 2015 ; 35 (4) : 2351-2357.

Language English Country Greece

Document type Journal Article, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc16000171

Grant support
NT13326 MZ0 CEP Register

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.

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