ADC测量技术在鉴别低级别和高级别透明细胞肾细胞癌中的应用。
The utility of ADC measurement techniques for differentiation of low- and high-grade clear cell RCC.
作者信息
Aslan Ahmet, İnan İbrahim, Aktan Ahmet, Ayaz Ercan, Aslan Mine, Özkanlı Sıdıka Şeyma, Yıldırım Asıf, Yıkılmaz Ali
机构信息
Department of Radiology, Istanbul Medeniyet University Göztepe Training and Research Hospital, Kadikoy, Istanbul, Turkey.
Department of Radiology, Adiyaman University Training and Research Hospital, Adiyaman, Turkey.
出版信息
Pol J Radiol. 2018 Sep 21;83:e446-e451. doi: 10.5114/pjr.2018.80207. eCollection 2018.
PURPOSE
To evaluate the diffusion properties of clear cell renal cell carcinoma (ccRCC) on magnetic resonance imaging (MRI) concerning their Fuhrman nuclear grades and sizes, and to compare the diagnostic performance of two ROI placement techniques for apparent diffusion coefficient (ADC) measurement (entire mass vs. only the darkest region of the mass).
MATERIAL AND METHODS
Fifty-one ccRCC were enrolled in the study and grouped into low-grade ccRCC (Fuhrman grade 1 and 2, = 37) and high-grade ccRCC (Fuhrman grade 3 and 4, = 14). Selective ADC (Sel-ADC) measurement was performed by placing a circular ROI that included the darkest region of the tumour on ADC map images. Extensive ADC (Ext-ADC) measurement was performed by drawing an ROI that covered the entire tumour.
RESULTS
The Sel-ADC value was lower in high-grade ccRCC ( = 0.019), whereas the Ext-ADC value did not show a statistically significant difference ( = 0.42). Sel-ADC value of a ≤ 1.405 mm/s has a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy value of 78.6, 72.2, 73.87, 77.13, and 75.4, respectively, to differentiate high-grade from low-grade ccRCC. The size and Fuhrman grade of the ccRCC were inversely correlated with the Sel-ADC value; however, the correlations were weak ( = -0.322, = 0.021 and = -0.376, = 0.006, respectively). There was no difference between ADC values of small (≤ 4 cm) and large (> 4 cm) ccRCCs.
CONCLUSIONS
The ADC value of the darkest region in solid part of the ccRCC may play a role in predicting the nuclear grade of ccRCC.
目的
在磁共振成像（MRI）上评估透明细胞肾细胞癌（ccRCC）的扩散特性与其Fuhrman核分级及大小的关系，并比较两种感兴趣区（ROI）放置技术用于表观扩散系数（ADC）测量（整个肿块与仅肿块最暗区域）的诊断性能。
材料与方法
51例ccRCC纳入本研究，分为低级别ccRCC（Fuhrman 1级和2级，n = 37）和高级别ccRCC（Fuhrman 3级和4级，n = 14）。通过在ADC图图像上放置包含肿瘤最暗区域的圆形ROI进行选择性ADC（Sel-ADC）测量。通过绘制覆盖整个肿瘤的ROI进行广泛ADC（Ext-ADC）测量。
结果
高级别ccRCC的Sel-ADC值较低（P = 0.019），而Ext-ADC值无统计学显著差异（P = 0.42）。对于区分高级别与低级别ccRCC，Sel-ADC值≤1.405 mm/s时，其灵敏度、特异度、阳性预测值、阴性预测值及准确度分别为78.6、72.2、73.87、77.13及75.4。ccRCC的大小和Fuhrman分级与Sel-ADC值呈负相关；然而，相关性较弱（分别为r = -0.322，P = 0.021和r = -0.376，P = 0.006）。小（≤4 cm）和大（>4 cm）ccRCC的ADC值之间无差异。
结论
ccRCC实性部分最暗区域的ADC值可能在预测ccRCC的核分级中起作用。
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