Renal cell carcinoma: applicability of the apparent coefficient of the diffusion-weighted estimated by MRI for improving their differential diagnosis, histologic subtyping, and differentiation grade

Abstract

The data received in our study demonstrate a substantial restriction of diffusion of hydrogen molecules in tissues of ccRCC in comparison with the healthy renal parenchyma preconditioned by the greater density of tumor. A statistically significant difference in mean ADC values of ccRCC with different grades of nuclear pleomorphism by Fuhrman was observed: Low-grade tumors showed higher mean ADC values compared to high-grade tumors. The modality of the MRI DWI along with ADC measurement allows to reliably differentiate between the solid RCC of main histologic subtypes and grades, cystic RCC, and the benign renal lesions.

Mono, bi- and tri-exponential diffusion MRI modelling for renal solid masses and comparison with histopathological findings

“…Previous studies applying DWI to evaluate kidney tumour type concluded that kidney lesions generally have a lower ADC than normal kidney tissue [ 13 , 17 , 29 ] and some studies also found a higher mean ADC value in benign lesions than in malignant lesions [ 15 , 30 , 31 ]. Studies typically find a higher ADC in oncocytomas than in RCCs [ 12 – 15 , 17 , 30 – 32 ] and therefore, ADC is likely to be a valuable parameter in evaluating tumour type.…”

Diagnostic Imaging for Solid Renal Tumors: A Pictorial Review

“…Several studies have shown that decreasing ADC values are found with increasing Fuhrman grade. This may be helpful in detecting high-grade ccRCCs [54,61].…”

A modern view on the effect of radiation exposure of patients during diagnostic evaluation of renal cell carcinoma and ways to avoid it

“…Our previous publications demonstrated high efficacy of the measuring of apparent diffusion coefficient of DWI. Its applica tion as the radiological biomarker of RCC allows to diagnose this pathology accurately and correctly as well as to carry out its differentiation from the benign kidney lesions avoiding the application of contrast substances [33,34].…”

“…За даними EAU така мо дальність МРТ, як дифузійно зважені зображення (ДЗЗ) володіє потенціалом для диференційної діаг ностики НКР [6], проте у жодному з досліджень не було наведено даних, достатніх для використання променевих біомаркерів НКР на основі МРТ зобра жень в широкій медичній практиці [29][30][31][32]. У наших попередніх публікаціях нами була продемонстрова на висока ефективність застосування вимірюваного коефіцієнта дифузії ДЗЗ МРТ у якості променевого біомаркеру НКР, що дозволяло не тільки достовірно діагностувати дану патологію, але й проводити її ди ференціацію з доброякісними нирковими новоутво реннями, уникаючи використання контрастних ре човин [33,34].…”