Renal clear cell carcinoma: diffusion tensor imaging diagnostic accuracy and correlations with clinical and histopathological factors.
OBJECTIVE
To investigate whether diffusion tensor imaging (DTI) can be used to assess renal clinical histopathology, including the nuclear grade (NG), cell density (CD), and the presence of ki-67.


METHODS
Thirty patients were enrolled in the study and were confirmed at surgical histopathology to have clear cell renal cell carcinoma (CCRCC). For DTI, a coronal echo-planar imaging sequence was performed (1400 ms repetition time, 76 ms echo time, diffusion direction=6, number of excitations=4; b=0 and 800 s/mm2, 6 mm section thickness with no intersection gap). CD and the presence of ki-67 were compared between the different NGs. Correlations between apparent diffusion coefficients (ADCs), E1, fractional anisotropy (FA), CD, and ki-67 were evaluated.


RESULTS
ADC, E1, and FA values are important tools used to identify NG. The cut-off values were 1.003×10-3mm2/s, 1.277×10-3mm2/s, and 0.218 mm2/s, respectively. The difference between high- and low-grade CD was significant (t=-4.50, p<0.05). Similarly, a significant difference between high and low grade was also found in ki-67 (t=-4.03, p<0.05). ADC, E1, and FA values were decreased with increased CD; a significant negative correlation was found (r=-0.796, -0.865, and -0.996, respectively). Significant negative correlations between ADC, E1, and FA values, and ki-67 were found (r=-0.739, -0.826, and -0.876, respectively).


CONCLUSIONS
DTI can be used to non-invasively assess CCRCC.
Department of Radiology, Yidu Central Hospital, Weifang Medical University, No. 4138, Linglongshansouth Road, Qingzhou City, Shandong Province, China.
Q
Q
Feng
Department of Radiology, Yidu Central Hospital, Weifang Medical University, No. 4138, Linglongshansouth Road, Qingzhou City, Shandong Province, China.
W
W
Fang
Department of Radiology, Yidu Central Hospital, Weifang Medical University, No. 4138, Linglongshansouth Road, Qingzhou City, Shandong Province, China.
X P
XP
Sun
Department of Radiology, Yidu Central Hospital, Weifang Medical University, No. 4138, Linglongshansouth Road, Qingzhou City, Shandong Province, China.
S H
SH
Sun
Department of Radiology, Yidu Central Hospital, Weifang Medical University, No. 4138, Linglongshansouth Road, Qingzhou City, Shandong Province, China.
R M
RM
Zhang
Department of Radiology, Yidu Central Hospital, Weifang Medical University, No. 4138, Linglongshansouth Road, Qingzhou City, Shandong Province, China. Electronic address: fengyixiao2002@163.com.
Z J
ZJ
Ma
D016880:Anisotropy; D002292:Carcinoma, Renal Cell / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000473:pathology*; D002452:Cell Count; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D007680:Kidney Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D015203:Reproducibility of Results
D019394:Ki-67 Antigen