Application of DWI with various b values in diagnosis of clear cell renal cell carcinoma Fuhrman grades

doi:10.3969/j.issn.1007-3969.2015.03.008

China Oncology ›› 2015, Vol. 25 ›› Issue (3): 205-210.doi: 10.3969/j.issn.1007-3969.2015.03.008

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Application of DWI with various b values in diagnosis of clear cell renal cell carcinoma Fuhrman grades

SHEN Lijuan^1,2, ZHOU Liangping², PENG Weijun², YANG Xiaoqun³, YUE Lei²

1.Department of Radiology, the Fifth People’s Hospital of Shanghai, Fudan University, Department of Gynecology and Obstetrics, Shanghai Medical College, Fudan University, Shanghai 200240, China; 2.Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 3.Department of Pathology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China

Online:2015-03-30 Published:2015-05-18
Contact: ZHOU Liangping E-mail: zhoulp2003@aliyun.com

Abstract

Abstract: Background and purpose: Renal cell carcinoma is the most common type of adult renal cancer, and the Fuhrman grading system is the most widely accepted independent indicator for the prognosis of kidney tumors. This study aimed to explore the correlation between the conventional diffusion weighted imaging (DWI) with various b values and Fuhrman grade of clear cell renal cancer, and assess the diagnostic efficiency of ADC values at different b values in differentiating Fuhrman low- and high-grade tumor. Methods: Thirty-three patients with pathologically proved clear cell renal cell cancer (CCRCC) and qualified images were included for the research. The diagnostic effi-ciency of ADC values at different b values for differentiating Fuhrman low- (1 and 2) and high-grade (3 and 4) tumor were also assessed and compared by receiver operator characteristic curve (ROC), and the optimum sensitivity, specificity and accuracy were selected using Youden index. Results: The 33 patients consist one tumor of Fuhrman grade 1, 14 of grade 2, 16 of grade 3 and 2 of grade 4. A negative correlation was found between the ADC_0-800, ADC_0-400-800, ADC_{0-600-1 200}, ADC_{0-400-800-1 200} and ADC_total with Fuhrman grade (r: -0.553, -0.511, -0.603, -0.645, -0.610, respectively), among these the ADC_{0-400-800-1200} showed the strongest correlation. The AUCs ［area under the (receiver operator characteristic curve) ROC curve］ of those parameters for differentiating the low- and high-grade tumor were 0.789, 0.757, 0.813, 0.844 and 0.835, among which the ADC_{0-400-800-1 200} reveal the best result, but the difference was not statistically significant (P>0.05). The sensitivity of the ADC values were 86.7%, 73.3%, 60.0%, 86.7% and 86.7%; The specificity were 66.7%, 77.8, 72.2%, 77.8% and 72.2%. Conclusion: ADC_0-800, ADC_0-400-800, ADC_{0-600-1 200}, ADC_{0-400-800-1 200} and ADC_total revealed significant correlation with the Fuhrman grade of clear cell renal cancer, and providing high diagnostic efficiency in differentiating Fuhrman low- and high-grade tumor.

Key words: Renal cell carcinoma, Fuhrman grade, Magnetic resonance imaging, Diffusion weighted imaging, Differential diagnosis

SHEN Lijuan, ZHOU Liangping, PENG Weijun, et al. Application of DWI with various b values in diagnosis of clear cell renal cell carcinoma Fuhrman grades[J]. China Oncology, 2015, 25(3): 205-210.

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Application of DWI with various b values in diagnosis of clear cell renal cell carcinoma Fuhrman grades

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