Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Comparison of Biexponential and Monoexponential Model of Diffusion-Weighted Imaging for Distinguishing between Common Renal Cell Carcinoma and Fat Poor Angiomyolipoma

  • Ding, Yuqin (Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging) ;
  • Zeng, Mengsu (Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging) ;
  • Rao, Shengxiang (Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging) ;
  • Chen, Caizhong (Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging) ;
  • Fu, Caixia (Siemens Shenzhen Magnetic Resonance Ltd.) ;
  • Zhou, Jianjun (Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging)
  • Received : 2015.10.31
  • Accepted : 2016.06.26
  • Published : 2016.11.01
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Abstract

Objective: To compare the diagnostic accuracy of intravoxel incoherent motion (IVIM)-derived parameters and apparent diffusion coefficient (ADC) in distinguishing between renal cell carcinoma (RCC) and fat poor angiomyolipoma (AML). Materials and Methods: Eighty-three patients with pathologically confirmed renal tumors were included in the study. All patients underwent renal 1.5T MRI, including IVIM protocol with 8 b values ($0-800s/mm^2$). The ADC, diffusion coefficient (D), pseudodiffusion coefficient ($D^*$), and perfusion fraction (f) were calculated. One-way ANOVA was used for comparing ADC and IVIM-derived parameters among clear cell RCC (ccRCC), non-ccRCC and fat poor AML. The diagnostic performance of these parameters was evaluated by using receiver operating characteristic (ROC) analysis. Results: The ADC were significantly greater in ccRCCs than that of non-ccRCCs and fat poor AMLs (each p < 0.010, respectively). The D and $D^*$ among the three groups were significantly different (all p < 0.050). The f of non-ccRCCs were less than that of ccRCCs and fat poor AMLs (each p < 0.050, respectively). In ROC analysis, ADC and D showed similar area under the ROC curve (AUC) values (AUC = 0.955 and 0.964, respectively, p = 0.589) in distinguishing between ccRCCs and fat poor AMLs. The combination of $D>0.97{\times}10^{-3}mm^2/s$, $D^*<28.03{\times}10^{-3}mm^2/s$, and f < 13.61% maximized the diagnostic sensitivity for distinguishing non-ccRCCs from fat poor AMLs. The final estimates of AUC (95% confidence interval), sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the entire cohort were 0.875 (0.719-0.962), 100% (23/23), 75% (9/12), 88.5% (23/26), 100% (9/9), and 91.4% (32/35), respectively. Conclusion: The ADC and D showed similar diagnostic accuracy in distinguishing between ccRCCs and fat poor AMLs. The IVIM-derived parameters were better than ADC in discriminating non-ccRCCs from fat poor AMLs.

Keywords

References

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