The utility of ADC measurement techniques for differentiation of low- and high-grade clear cell RCC

Abstract

PurposeTo evaluate the diffusion properties of clear cell renal cell carcinoma (ccRCC) on magnetic resonance imaging (MRI) concerning their Fuhrman nuclear grades and sizes, and to compare the diagnostic performance of two ROI placement techniques for apparent diffusion coefficient (ADC) measurement (entire mass vs. only the darkest region of the mass).Material and methodsFifty-one ccRCC were enrolled in the study and grouped into low-grade ccRCC (Fuhrman grade 1 and 2, n = 37) and high-grade ccRCC (Fuhrman grade 3 and 4, n = 14). Selective ADC (Sel-ADC) measurement was performed by placing a circular ROI that included the darkest region of the tumour on ADC map images. Extensive ADC (Ext-ADC) measurement was performed by drawing an ROI that covered the entire tumour.ResultsThe Sel-ADC value was lower in high-grade ccRCC (p = 0.019), whereas the Ext-ADC value did not show a statistically significant difference (p = 0.42). Sel-ADC value of a ≤ 1.405 mm2/s has a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy value of 78.6, 72.2, 73.87, 77.13, and 75.4, respectively, to differentiate high-grade from low-grade ccRCC. The size and Fuhrman grade of the ccRCC were inversely correlated with the Sel-ADC value; however, the correlations were weak (r = –0.322, p = 0.021 and r = –0.376, p = 0.006, respectively). There was no difference between ADC values of small (≤ 4 cm) and large (> 4 cm) ccRCCs.ConclusionsThe ADC value of the darkest region in solid part of the ccRCC may play a role in predicting the nuclear grade of ccRCC.

Differentiation of low and high grade renal cell carcinoma on routine MRI with an externally validated automatic machine learning algorithm

“…In such cases, ADC measurements are taken using different region-of-interest (ROI) placement techniques to distinguish between low and high grade. A study using ADC differentiation by Aslan et al demonstrates an accuracy value of 0.75 whereas our study displays a top accuracy of 0.81 23 . ML-based radiomics methods have potential to enhance differentiation based on grade compared to manual ADC computation.…”

Associations Between Apparent Diffusion Coefficient Value With Pathological Type, Histologic Grade, and Presence of Lymph Node Metastases of Esophageal Carcinoma

“…Tanaka et al 22 found that high-grade tumors had lower ADC values than low-grade tumors among 91 patients with endometrioid endometrial cancer. Ahmet et al 23 demonstrated that the size and Fuhrman grade of the clear cell renal cell carcinoma were inversely correlated with the ADC value. Yazdani et al 24 showed that significantly lower mean ADC values in high-grade compared to low-grade gliomas.…”