Keywords:
Cancer, Imaging sequences, Comparative studies, MR-Diffusion/Perfusion, MR, Abdomen
Authors:
G. YILMAZ1, B. S. Seker2, N. Köse1, M. Atalar1, H. Egilmez2; 1SİVAS/TR, 2SIVAS/TR
DOI:
10.1594/ecr2018/C-0809
Methods and materials
The Institutional Review Board approved this retrospective study,
and informed consent was waived.
PACS (Picture archiving and communication system) was reviewed from August 2012 to May 2017 and 36 patients underwent renal intervention and had a histopathological diagnosis of the various renal disease were obtained.
Of them,
surgery or tru-cut biopsy is performed for renal mass in 27 patients.
Two patients were excluded from the study as their histopathological results showed pathology other than RCC,
including angiomyolipoma in 1 patient and transitional cell carcinoma in 1 patient.
9 patients were excluded had no histopathological examination.
Twenty five patients were included in the study.
All patients were scanned using the 1.5 T MRI machine (Siemens Magnetom).
All had apparent diffusion coefficient (ADC) values calculation for normal and diseased renal tissues.
The DWI studies for all patients were independently reviewed by two radiologists and then correlated with the pathology results.
Multiple Regions of Interest (ROI)s for obtaining ADC values were placed within the masses and in renal parenchyma not involved by the disease.
Using the same ROIs for signal intensity calculation.
Two different ADC measurements were performed on each RCC at three different axial planes,
and the mean ADC values were noted.
The first ADC measurement,
named as diffuse ADC,
was performed by drawing a ROI that covered the whole tumor.
The second measurement,
named as selective ADC (sel-ADC).
The size of the ROIs was 10 mm2.
Care was taken to place the ROIs in the solid component of the mass and avoid areas of cystic degeneration and necrosis.
The mean ADC value for all ROIs within the lesion was used for analysis.
Mann-Whitney U test was used to evaluate differences in the ADC values between RCC and uninvolved renal parenchyma,
and between the different renal cell carcinoma subtypes.
The data collected from papillary RCCs and chromophobic RCCs were combined into one group to focus on differentiation between clear cell and non-clear cell RCCs.
Correlation analysis were used to show the correlations of Fuhrman grades of RCCs.
Analytic statistics were calculated using SPSS (ver.
22) statistical software,
p <0.05 was considered significant.