Diffusion-weighted and diffusion kurtosis imaging analysis of microstructural differences in clear cell renal cell...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Clear cell renal cell carcinoma (CRCC) grading is crucial for prognosis and treatment.
• Conventional diffusion-weighted imaging (DWI) provides microstructural information but has limitations in differentiating CRCC grades.
• Diffusion kurtosis imaging (DKI) offers advanced insights into tissue microstructure beyond DWI.

Purpose of the Study:

• To quantitatively compare the diagnostic performance of DWI and DKI in assessing microstructural differences for CRCC grading.
• To determine which imaging technique is more effective in differentiating low-grade from high-grade CRCC.

Main Methods:

• 108 patients with pathologically confirmed CRCC were analyzed.
• Apparent diffusion coefficient (ADC), mean diffusivity (MD), mean kurtosis (MK), kurtosis anisotropy (KA), and radial kurtosis (RK) were calculated.
• Receiver operating characteristic (ROC) curve analysis was used to compare diagnostic efficacy.

Main Results:

• ADC and MD values negatively correlated with CRCC tumor grading.
• MK, KA, and RK values positively correlated with CRCC tumor grading.
• MD demonstrated the highest diagnostic efficacy in differentiating low/high and Grade II/III CRCC, with an AUC of 0.937.

Conclusions:

• DKI analysis, particularly MD, shows superior diagnostic value compared to conventional ADC in differentiating CRCC grades.
• DKI provides more sensitive microstructural information for CRCC grading than DWI.