To characterize small renal cell carcinoma using diffusion relaxation correlation spectroscopic imaging and apparent diffusion coefficient based histogram analysis: a preliminary study

Yongming Dai; Mengying Zhu; Wentao Hu; Dongmei Wu; Shenyun He; Yuansheng Luo; Xiaobin Wei; Yan Zhou; Guangyu Wu; Peng Hu

doi:10.1007/s11547-024-01819-6

To characterize small renal cell carcinoma using diffusion relaxation correlation spectroscopic imaging and apparent diffusion coefficient based histogram analysis: a preliminary study

Radiol Med. 2024 Apr 25. doi: 10.1007/s11547-024-01819-6. Online ahead of print.

Authors

Yongming Dai^#¹, Mengying Zhu^#², Wentao Hu², Dongmei Wu³, Shenyun He², Yuansheng Luo², Xiaobin Wei², Yan Zhou², Guangyu Wu⁴, Peng Hu⁵

Affiliations

¹ School of Biomedical Engineering & State Key Laboratory of Advanced Medical Materials and Devices & Shanghai Clinical Research and Trial Center, ShanghaiTech University, Shanghai, China.
² Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
³ Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China.
⁴ Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. danielrau@163.com.
⁵ School of Biomedical Engineering & State Key Laboratory of Advanced Medical Materials and Devices & Shanghai Clinical Research and Trial Center, ShanghaiTech University, Shanghai, China. hupeng@shanghaitech.edu.cn.

^# Contributed equally.

PMID: 38662246
DOI: 10.1007/s11547-024-01819-6

Abstract

Purpose: To study the capability of diffusion-relaxation correlation spectroscopic imaging (DR-CSI) on subtype classification and grade differentiation for small renal cell carcinoma (RCC). Histogram analysis for apparent diffusion coefficient (ADC) was studied for comparison.

Materials and methods: A total of 61 patients with small RCC (< 4 cm) were included in the retrospective study. MRI data were reviewed, including a multi-b (0-1500 s/mm²) multi-TE (51-200 ms) diffusion weighted imaging (DWI) sequence. Region of interest (ROI) was delineated manually on DWI to include solid tumor. For each patient, a D-T2 spectrum was fitted and segmented into 5 compartments, and the volume fractions V_A, V_B, V_C, V_D, V_E were obtained. ADC mapping was calculated, and histogram parameters ADC 90th, 10th, median, standard deviation, skewness and kurtosis were obtained. All MRI metrices were compared between clear cell RCC (ccRCC) and non-ccRCC group, and between high-grade and low-grade group. Receiver operator curve analysis was used to assess the corresponding diagnostic performance.

Results: Significantly higher ADC 90th, ADC 10th and ADC median, and significantly lower DR-CSI V_B was found for ccRCC compared to non-ccRCC. Significantly lower ADC 90th, ADC median and significantly higher V_B was found for high-grade RCC compared to low-grade. For identifying ccRCC from non-ccRCC, V_B showed the highest area under curve (AUC, 0.861) and specificity (0.882). For differentiating high- from low-grade, ADC 90th showed the highest AUC (0.726) and specificity (0.786), while V_B also displayed a moderate AUC (0.715).

Conclusion: DR-CSI may offer improved accuracy in subtype identification for small RCC, while do not show better performance for small RCC grading compared to ADC histogram.

Keywords: Diffusion Relaxation Correlation Spectroscopic Imaging; Histogram analysis; Renal cell carcinoma; Tumor heterogeneity.