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Differentiation of solid and friable tumour thrombus in patients with renal cell carcinoma: The role of MRI apparent diffusion coefficient

P. Kowal, K. Ratajczyk, W. Bursiewicz, M. Trzciniecki, K. Marek-Bukowiec, J. Rogala, V. Kowalskyi, J. Dragasek, A. Botikova, P. Kruzliak, Y. Mytsyk

. 2024 ; 69 (2) : 434-442. [pub] 20240914

Jazyk angličtina Země Nizozemsko

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc25004123

PURPOSE: Inferior vena cava (IVC) involvement by renal cell carcinoma (RCC) is associated with a higher disease stage and is considered a risk factor for poor prognosis. This study aimed to investigate the role of the apparent diffusion coefficient (ADC) of MRI 3D texture analysis in the differentiation of solid and friable tumour thrombus in patients with RCC. MATERIALS AND METHODS: The study involved 27 patients with RCC with tumour thrombus in the renal vein or IVC, surgically treated with nephrectomy and thrombectomy and in whom preoperatively abdominal MRI including the DWI sequence was conducted. For 3D texture analysis, the ADC map was used, and the first-order radiomic features were calculated from the whole volume of the thrombus. All tumour thrombi were histologically classified as solid or friable. RESULTS: The solid and friable thrombus was detected in 51.9 ​% and 48.1 ​% of patients, respectively. No differences in mean values of range, 90th percentile, interquartile range, kurtosis, uniformity and variance were found between groups. Equal sensitivity and specificity (93 ​% and 69 ​%, respectively) of ADC mean, median and entropy in differentiation between solid and friable tumour thrombus, with the highest AUC for entropy (0.808), were observed. Applying the skewness threshold value of 0.09 allowed us to achieve a sensitivity of 86 ​% and a specificity of 92 ​%. CONCLUSIONS: In patients with RCC and tumour thrombus in the renal vein or IVC, the 3D texture analysis based on ADC-map allows for precise differentiation of a solid from a friable thrombus.

Citace poskytuje Crossref.org

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$a PURPOSE: Inferior vena cava (IVC) involvement by renal cell carcinoma (RCC) is associated with a higher disease stage and is considered a risk factor for poor prognosis. This study aimed to investigate the role of the apparent diffusion coefficient (ADC) of MRI 3D texture analysis in the differentiation of solid and friable tumour thrombus in patients with RCC. MATERIALS AND METHODS: The study involved 27 patients with RCC with tumour thrombus in the renal vein or IVC, surgically treated with nephrectomy and thrombectomy and in whom preoperatively abdominal MRI including the DWI sequence was conducted. For 3D texture analysis, the ADC map was used, and the first-order radiomic features were calculated from the whole volume of the thrombus. All tumour thrombi were histologically classified as solid or friable. RESULTS: The solid and friable thrombus was detected in 51.9 ​% and 48.1 ​% of patients, respectively. No differences in mean values of range, 90th percentile, interquartile range, kurtosis, uniformity and variance were found between groups. Equal sensitivity and specificity (93 ​% and 69 ​%, respectively) of ADC mean, median and entropy in differentiation between solid and friable tumour thrombus, with the highest AUC for entropy (0.808), were observed. Applying the skewness threshold value of 0.09 allowed us to achieve a sensitivity of 86 ​% and a specificity of 92 ​%. CONCLUSIONS: In patients with RCC and tumour thrombus in the renal vein or IVC, the 3D texture analysis based on ADC-map allows for precise differentiation of a solid from a friable thrombus.
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$a Ratajczyk, Krzysztof $u Department of Urology, Regional Specialist Hospital, Wroclaw, Poland
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$a Bursiewicz, Wiktor $u Department of Urology, Regional Specialist Hospital, Wroclaw, Poland
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$a Trzciniecki, Maciej $u Department of Urology, Regional Specialist Hospital, Wroclaw, Poland
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$a Marek-Bukowiec, Karolina $u Research and Development Center, Regional Specialist Hospital, Wroclaw, Poland
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$a Rogala, Joanna $u Department of Pathology, Regional Specialist Hospital, Wroclaw, Poland
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$a Kowalskyi, Vasyl $u Department of Oncology and Radiology, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
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$a Dragasek, Jozef $u Faculty of Medicine, Pavol Jozef Safarik University and University Hospital, Kosice, Slovakia
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$a Botikova, Andrea $u Faculty of Health and Social Work, Trnava University, Trnava, Slovakia
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$a Kruzliak, Peter $u 2nd Department of Surgery, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic. Electronic address: kruzliakpeter@gmail.com
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$a Mytsyk, Yulian $u Department of Urology, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
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