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Abstract：
BACKGROUND: Clinical imaging tools to probe aggressiveness of renal masses are lacking, and T2-weighted imaging as an integral part of magnetic resonance imaging protocol only provides qualitative information. We developed high-resolution and accelerated T2 mapping methods based on echo merging and using k-t undersampling and reduced flip angles (TEMPURA) and tested their potential to quantify differences between renal tumour subtypes and grades.
METHODS: Twenty-four patients with treatment-naïve renal tumours were imaged: seven renal oncocytomas (RO); one eosinophilic/oncocytic renal cell carcinoma; two chromophobe RCCs (chRCC); three papillary RCCs (pRCC); and twelve clear cell RCCs (ccRCC). Median, kurtosis, and skewness of T2 were quantified in tumours and in the normal-adjacent kidney cortex and were compared across renal tumour subtypes and between ccRCC grades.
RESULTS: High-resolution TEMPURA depicted the tumour structure at improved resolution compared to conventional T2-weighted imaging. The lowest median T2 values were present in pRCC (high-resolution, 51 ms; accelerated, 45 ms), which was significantly lower than RO (high-resolution; accelerated, p = 0.012) and ccRCC (high-resolution, p = 0.019; accelerated, p = 0.008). ROs showed the lowest kurtosis (high-resolution, 3.4; accelerated, 4.0), suggestive of low intratumoural heterogeneity. Lower T2 values were observed in higher compared to lower grade ccRCCs (grades 2, 3 and 4 on high-resolution, 209 ms, 151 ms, and 106 ms; on accelerated, 172 ms, 160 ms, and 102 ms, respectively), with accelerated TEMPURA showing statistical significance in comparison (p = 0.037).
CONCLUSIONS: Both high-resolution and accelerated TEMPURA showed marked potential to quantify differences across renal tumour subtypes and between ccRCC grades.
BACKGROUND: ClinicalTrials.gov, NCT03741426 . Registered on 13 November 2018.
CONCLUSIONS: The newly developed T2 mapping methods have improved resolution, shorter acquisition times, and promising quantifiable readouts to characterise incidental renal masses.
METHODS: Twenty-four patients with treatment-naïve renal tumours were imaged: seven renal oncocytomas (RO); one eosinophilic/oncocytic renal cell carcinoma; two chromophobe RCCs (chRCC); three papillary RCCs (pRCC); and twelve clear cell RCCs (ccRCC). Median, kurtosis, and skewness of T2 were quantified in tumours and in the normal-adjacent kidney cortex and were compared across renal tumour subtypes and between ccRCC grades.
RESULTS: High-resolution TEMPURA depicted the tumour structure at improved resolution compared to conventional T2-weighted imaging. The lowest median T2 values were present in pRCC (high-resolution, 51 ms; accelerated, 45 ms), which was significantly lower than RO (high-resolution; accelerated, p = 0.012) and ccRCC (high-resolution, p = 0.019; accelerated, p = 0.008). ROs showed the lowest kurtosis (high-resolution, 3.4; accelerated, 4.0), suggestive of low intratumoural heterogeneity. Lower T2 values were observed in higher compared to lower grade ccRCCs (grades 2, 3 and 4 on high-resolution, 209 ms, 151 ms, and 106 ms; on accelerated, 172 ms, 160 ms, and 102 ms, respectively), with accelerated TEMPURA showing statistical significance in comparison (p = 0.037).
CONCLUSIONS: Both high-resolution and accelerated TEMPURA showed marked potential to quantify differences across renal tumour subtypes and between ccRCC grades.
BACKGROUND: ClinicalTrials.gov, NCT03741426 . Registered on 13 November 2018.
CONCLUSIONS: The newly developed T2 mapping methods have improved resolution, shorter acquisition times, and promising quantifiable readouts to characterise incidental renal masses.
摘要：
背景：目前尚缺乏探测肾脏肿块侵袭性的临床成像工具，而T2加权成像作为磁共振成像协议的组成部分仅提供定性信息。我们基于回波合并并使用k-t欠采样和减小的翻转角（TEMPURA）开发了高分辨率和加速的T2映射方法，并测试了其量化肾脏肿瘤亚型和等级之间差异的潜力。
方法：对24例初治肾肿瘤患者进行成像：7例肾嗜酸细胞瘤（RO）；1例嗜酸性/嗜酸性肾细胞癌；2例发色细胞RCC（chRCC）；3例乳头状RCC（pRCC）；12例透明细胞RCC（ccRCC）。median,峰度,在肿瘤和正常-邻近肾皮质中量化T2的偏度，并在肾脏肿瘤亚型和ccRCC等级之间进行比较。
结果：与常规T2加权成像相比，高分辨率TEMPURA以提高的分辨率描绘了肿瘤结构。pRCC中存在最低的T2中值(高分辨率，51ms;加速,45ms)，显著低于RO(高分辨率；加速，p=0.012)和ccRCC(高分辨率，p=0.019；加速，p=0.008)。RO显示出最低的峰度(高分辨率，3.4；加速，4.0),提示肿瘤内异质性低。与较低等级的ccRCC相比，在较高的地方观察到较低的T2值（高分辨率的等级2、3和4，209毫秒，151ms,和106毫秒；在加速时，172ms,160ms,和102毫秒，分别)，与加速TEMPURA相比显示统计学意义(p=0.037)。
结论：高分辨率TEMPURA和加速TEMPURA都显示出明显的潜力，可以量化肾脏肿瘤亚型之间和ccRCC等级之间的差异。
背景：ClinicalTrials.gov，NCT03741426。2018年11月13日注册。
结论：新开发的T2作图方法提高了分辨率，更短的采集时间，和有希望的可量化读数来表征偶然的肾脏肿块。
方法：对24例初治肾肿瘤患者进行成像：7例肾嗜酸细胞瘤（RO）；1例嗜酸性/嗜酸性肾细胞癌；2例发色细胞RCC（chRCC）；3例乳头状RCC（pRCC）；12例透明细胞RCC（ccRCC）。median,峰度,在肿瘤和正常-邻近肾皮质中量化T2的偏度，并在肾脏肿瘤亚型和ccRCC等级之间进行比较。
结果：与常规T2加权成像相比，高分辨率TEMPURA以提高的分辨率描绘了肿瘤结构。pRCC中存在最低的T2中值(高分辨率，51ms;加速,45ms)，显著低于RO(高分辨率；加速，p=0.012)和ccRCC(高分辨率，p=0.019；加速，p=0.008)。RO显示出最低的峰度(高分辨率，3.4；加速，4.0),提示肿瘤内异质性低。与较低等级的ccRCC相比，在较高的地方观察到较低的T2值（高分辨率的等级2、3和4，209毫秒，151ms,和106毫秒；在加速时，172ms,160ms,和102毫秒，分别)，与加速TEMPURA相比显示统计学意义(p=0.037)。
结论：高分辨率TEMPURA和加速TEMPURA都显示出明显的潜力，可以量化肾脏肿瘤亚型之间和ccRCC等级之间的差异。
背景：ClinicalTrials.gov，NCT03741426。2018年11月13日注册。
结论：新开发的T2作图方法提高了分辨率，更短的采集时间，和有希望的可量化读数来表征偶然的肾脏肿块。
