确定肾细胞癌(RCC)中最常用的不同表观扩散系数(ADC)测量方法,以及它们与国际泌尿外科病理学会(ISUP)组织学分级系统的相关性。
本研究共纳入了99例患者,这些患者接受了弥散加权成像,病理诊断为RCC。作为文献综述的结果,感兴趣区域(ROI)的选择和测量方法以五种方式确定。这些包括病变实体部分的小ROI(ADC1)显示出最大的限制;病变实体部分的大ROI(ADC2)显示出限制;ROI(ADC3)在横截面中以最大的直径覆盖病变,这是通过将ROIs(ADC4)覆盖在病变的所有切片上而获得的;在病变的实体部分上的三个小ROIs(ADC5)显示出最大的局限性。然后,从对侧正常肾实质进行ADC测量。肿瘤病理细分[71透明细胞RCC(ccRCC),17个发色RCC(chRCC),11个乳头状RCC(pRCC)],并根据ISUP核分级系统(42个高等级,57低等级)。对数据进行统计分析。
在所有测量方法中,RCCs的ADC值明显低于正常肾脏的ADC值。RCC的ADC3和ADC4测量值之间没有差异(p=0.999)。其他测量方法存在统计学差异(p<0.001)。在所有测量方法中,ccRCC与pRCC和chRCC之间存在差异。在所有测量方法中,pRCC和chRCCADC值低于ccRCCADC值。当ISUP核分级和ADC值进行比较时,所有ADC测量值之间存在统计学上的负相关.在ADC1和ADC5测量中发现最强的相关性。当比较ISUP低年级和高年级组的ADC值时,在ADC5测量方法中发现显著差异(p=0.046).
根据研究结果,ADC5是与ISUP组织学分级系统显示最佳相关性的测量方法。因此,我们认为ADC5可以作为确定RCCADC值的主要测量方法。
To determine the most frequently used different apparent diffusion coefficient (ADC) measurement methods in renal cell carcinoma (RCC), and their correlation with the International Society of Urological Pathology (
ISUP) histologic grading system.
A total of 99 patients who underwent diffusion-weighted imaging and whose pathologic diagnosis of RCC was confirmed were included in the study. As a result of a literature review, region of interest (ROI) selection and measurement methods were determined in five ways. These included a small ROI (ADC1) on the solid part of the lesion showing the most restriction; a large ROI (ADC2) on the solid part of the lesion showing restriction; ROI (ADC3) that covered the lesion in the cross-section with the largest diameter, which was obtained by placing ROIs (ADC4) covering the lesion on all sections of the lesion; three small ROIs (ADC5) on solid parts of the lesion showing the most restriction. Then, ADC measurements were made from the contralateral normal kidney parenchyma. Tumors were pathologically subdivided [71 clear cell RCCs (ccRCC), 17 chromophobe RCCs (chRCC), 11 papillary RCCs (pRCC)], and graded according to the
ISUP nuclear grading system (42 high-grade, 57 low-grade). Data were analyzed statistically.
In all measurement methods, ADC values of RCCs were statistically significantly lower than normal kidney ADC values. There were no differences between the ADC3 and ADC4 measurements of RCCs (p = 0.999). There was a statistical difference in other measurement methods (p < 0.001). There were differences between ccRCCs and pRCCs and chRCCs in all measurement methods. In all measurement methods, pRCC and chRCC ADC values were lower than ccRCC ADC values. When
ISUP nuclear grading and ADC values were compared, there was a statistically inverse correlation between all ADC measurements. The strongest correlation was found in the ADC1 and ADC5 measurements. When the ADC values of
ISUP low and high-grade groups were compared, a significant difference was found in the ADC5 measurement method (p = 0.046).
According to the findings of the study, ADC5 is the measurement method that shows the best correlation with the
ISUP histologic grading system. Therefore, we think that ADC5 can be the primary measurement method for determining the ADC value of RCCs.