Grading of clear cell renal cell carcinoma using diffusion MRI with a multimodal apparent diffusion model

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Clear cell renal cell carcinoma (ccRCC) grading is crucial for treatment planning.
• Accurate non-invasive methods for distinguishing ccRCC grades are needed.

Purpose of the Study:

• To evaluate the feasibility of using multimodal apparent diffusion (MAD) model parameters to differentiate low-grade from high-grade ccRCC.
• To compare the diagnostic performance of MAD parameters with the apparent diffusion coefficient (ADC) from a mono-exponential model.

Main Methods:

• Diffusion-weighted imaging (DWI) with 12 b-values was performed on 54 ccRCC patients.
• MAD model parameters (Dr, Dh, Dui, Df, fr, fh, fui, ff, αh) were computed.
• Parameters were compared between low- and high-grade ccRCC groups, and ROC curves assessed diagnostic performance.

Main Results:

• Significant differences were found in Dh, fr, and αh between low- and high-grade ccRCC.
• ADC values also showed significant differences.
• The combination of Dh, fr, and αh achieved the highest diagnostic accuracy (0.667) and AUC (0.796), outperforming individual parameters and ADC.

Conclusions:

• The MAD diffusion model shows potential as a non-invasive tool for distinguishing ccRCC grades.
• This approach may assist in preoperative planning and personalized treatment strategies for ccRCC.