Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK.
The Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
Eur Radiol Exp. 2024 Jul 10;8(1):76. doi: 10.1186/s41747-024-00476-8.
Clinical imaging tools to probe aggressiveness of renal masses are lacking, and T2-weighted imaging as an integral part of magnetic resonance imaging protocol only provides qualitative information. We developed high-resolution and accelerated T2 mapping methods based on echo merging and using k-t undersampling and reduced flip angles (TEMPURA) and tested their potential to quantify differences between renal tumour subtypes and grades.
Twenty-four patients with treatment-naïve renal tumours were imaged: seven renal oncocytomas (RO); one eosinophilic/oncocytic renal cell carcinoma; two chromophobe RCCs (chRCC); three papillary RCCs (pRCC); and twelve clear cell RCCs (ccRCC). Median, kurtosis, and skewness of T2 were quantified in tumours and in the normal-adjacent kidney cortex and were compared across renal tumour subtypes and between ccRCC grades.
High-resolution TEMPURA depicted the tumour structure at improved resolution compared to conventional T2-weighted imaging. The lowest median T2 values were present in pRCC (high-resolution, 51 ms; accelerated, 45 ms), which was significantly lower than RO (high-resolution; accelerated, p = 0.012) and ccRCC (high-resolution, p = 0.019; accelerated, p = 0.008). ROs showed the lowest kurtosis (high-resolution, 3.4; accelerated, 4.0), suggestive of low intratumoural heterogeneity. Lower T2 values were observed in higher compared to lower grade ccRCCs (grades 2, 3 and 4 on high-resolution, 209 ms, 151 ms, and 106 ms; on accelerated, 172 ms, 160 ms, and 102 ms, respectively), with accelerated TEMPURA showing statistical significance in comparison (p = 0.037).
Both high-resolution and accelerated TEMPURA showed marked potential to quantify differences across renal tumour subtypes and between ccRCC grades.
ClinicalTrials.gov, NCT03741426 . Registered on 13 November 2018.
The newly developed T mapping methods have improved resolution, shorter acquisition times, and promising quantifiable readouts to characterise incidental renal masses.
目前缺乏用于探测肾肿块侵袭性的临床成像工具，磁共振成像（MRI）方案中的 T2 加权成像仅提供定性信息。我们开发了基于回波合并的高分辨率和加速 T2 映射方法，利用 k-t 欠采样和减少翻转角（TEMPURA），并测试了其量化肾肿瘤亚型和分级之间差异的潜力。
对 24 例未经治疗的肾肿瘤患者进行了成像：7 例肾嗜酸细胞瘤（RO）；1 例嗜酸细胞/嗜酸细胞瘤肾细胞癌；2 例嫌色细胞肾细胞癌（chRCC）；3 例乳头状肾细胞癌（pRCC）；12 例透明细胞肾细胞癌（ccRCC）。在肿瘤和正常邻近肾皮质中定量了 T2 的中位数、峰度和偏度，并比较了肾肿瘤亚型之间和 ccRCC 分级之间的差异。
与常规 T2 加权成像相比，高分辨率 TEMPURA 可更清晰地描绘肿瘤结构。pRCC 的 T2 值最低（高分辨率，51ms；加速，45ms），明显低于 RO（高分辨率，加速，p=0.012）和 ccRCC（高分辨率，加速，p=0.019）。RO 表现出最低的峰度（高分辨率，3.4；加速，4.0），提示肿瘤内异质性较低。与低级别 ccRCC 相比，高级别 ccRCC 的 T2 值更低（高分辨率，2 级、3 级和 4 级分别为 209ms、151ms 和 106ms；加速，2 级、3 级和 4 级分别为 172ms、160ms 和 102ms），加速 TEMPURA 在比较中具有统计学意义（p=0.037）。
高分辨率和加速 TEMPURA 均显示出在肾肿瘤亚型和 ccRCC 分级之间定量差异的巨大潜力。
ClinicalTrials.gov，NCT03741426。2018 年 11 月 13 日注册。
新开发的 T 映射方法具有提高分辨率、缩短采集时间的优点，有望提供可量化的读数来对偶然发现的肾肿块进行特征描述。
