title: Usefulness of diffusion tensor imaging for the differentiation between low-fat angiomyolipoma and clear cell carcinoma of the kidney.
abstract: To investigate the value of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in differentiating clear-cell renal cell carcinoma (CCRCC) from low-fat renal angiomyolipomas (RAML), and to obtain the optimal b value. Fifty patients, including 30 cases of CCRCC and 20 cases of low-fat RAML, were retrospectively recruited to participate in this study. Before renal nephrectomy, all subjects underwent functional magnetic resonance imaging. For diffusion tensor imaging (DTI), a respiratory-triggered coronal echo planar imaging sequence was performed with three groups of different b values (0 and 400, 600, and 800). The ADC and FA of kidneys were analyzed and compared between different b values using analysis of variance. Receiver operation characteristic analysis was computed to assess the diagnostic performance of ADC and FA in differentiating low-fat RAML from CCRCC and to determine the optimal b values. With either CCRCC or low-fat RAML, the ADC values decreased with increased b values and significant differences were observed (F = 11.34, 23.15, P < 0.05), while the FA values were not significantly different (F = 0.28, 2.80, P > 0.05). The statistical differences in ADC, and the FA values for CCRCC and low-fat RAML were significantly different (P < 0.05). When the b value was 0.800 s/mm(2), the cutoff FA value for differentiating CCRCC from low-fat RAML was 0.254 × 10.3 mm(2)/s, and had a sensitivity of 100 %, and a specificity of 73.3 %. MR-DTI can be used to differentiate CCRCC from low-fat RAML.
authors.affiliation: Department of Radiology, Affiliated Yidu Central Hospital, Weifang Medical University, Weifang, 262500 Shandong People's Republic of China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Feng
authors.affiliation: Department of Radiology, Affiliated Yidu Central Hospital, Weifang Medical University, Weifang, 262500 Shandong People's Republic of China.
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Ma
authors.affiliation: Department of Radiology, Affiliated Yidu Central Hospital, Weifang Medical University, Weifang, 262500 Shandong People's Republic of China.
authors.forename: Sujuan
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Affiliated zhongshan Hospital, Dalian University, No. 6 jiefang Road, Zhongshan District, Dalian, 116001 Liaoning People's Republic of China.
authors.forename: Jianlin
authors.initials: J
authors.lastname: Wu
keywords: Clear cell renal cell carcinomas; Diffusion tensor imaging; Fractional anisotropy; Renal angiomyolipomas