Apparent diffusion coefficient: An associative factor for recurrence after nephrectomy in localized renal cell...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Renal cell carcinoma (RCC) recurrence after nephrectomy poses a significant clinical challenge.
• Predictive biomarkers for post-surgical recurrence are crucial for personalized treatment strategies.

Purpose of the Study:

• To determine if tumor apparent diffusion coefficient (ADC) measured via MRI correlates with recurrence risk in localized RCC patients post-nephrectomy.
• To identify ADC as a potential independent predictor of disease-free survival.

Main Methods:

• Retrospective analysis of 49 localized RCC patients undergoing preoperative 1.5T MRI with diffusion-weighted imaging.
• Measurement of average and minimum ADC values from tumor regions.
• Cox proportional hazards modeling to assess correlations with clinicopathological factors and disease-free survival.

Main Results:

• Univariate analysis revealed significant correlations between tumor size, venous invasion, mean ADC, and minimum ADC with disease-free survival.
• Multivariate analysis identified venous invasion and minimum ADC as independent predictors of recurrence (P < 0.05).
• Patients with low minimum ADC had a 5-year disease-free survival rate of 51.6% versus 85.1% in the high minimum ADC group.

Conclusions:

• Minimum ADC is an independent associative factor for recurrence after nephrectomy in localized RCC.
• While venous invasion is a stronger predictor, minimum ADC offers valuable prognostic information.
• Diffusion-weighted MRI may aid in risk stratification for RCC patients.