Textural differences in apparent diffusion coefficient between low- and high-stage clear cell renal cell carcinoma.

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Clear cell renal cell carcinoma (RCC) staging is crucial for treatment planning.
• Accurate noninvasive staging of RCC remains a clinical challenge.
• Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping offer insights into tissue microstructure.

Purpose of the Study:

• To evaluate differences in texture measures on apparent diffusion coefficient (ADC) maps between low- and high-stage clear cell renal cell carcinomas (RCCs).
• To determine if ADC-derived texture features can aid in noninvasive RCC staging.

Main Methods:

• Retrospective analysis of 61 patients with clear cell RCC who underwent preoperative MRI with DWI.
• Segmentation of whole lesions on ADC maps to calculate first-order (mean, skewness) and second-order (cooccurrence matrix) texture features.
• Comparison of texture metrics between pathologically confirmed low-stage (I-II) and high-stage (III-IV) clear cell RCCs.

Main Results:

• High-stage clear cell RCCs were significantly larger and exhibited higher ADC skewness and cooccurrence matrix correlation compared to low-stage RCCs.
• No significant difference in mean ADC values was observed between low- and high-stage clear cell RCCs.
• A multivariate logistic regression model incorporating size, skewness, and cooccurrence matrix correlation achieved an AUC of 0.92 for predicting high stage.

Conclusions:

• First- and second-order ADC texture metrics demonstrate significant differences between low- and high-stage clear cell RCCs.
• A combination of tumor size and ADC texture measures shows promise for noninvasive staging of clear cell RCC.
• These findings suggest a potential role for advanced MRI texture analysis in refining RCC staging and guiding clinical management.