Malignant renal neoplasms: correlation between ADC values and cellularity in diffusion weighted magnetic resonance imaging at 3 T

Purpose. This study aimed at exploring the feasibility of high-field diffusion-weighted magnetic resonance imaging (DW-MRI) (3 T) and to correlate apparent diffusion coefficient (ADC) values with tumour cellularity in renal malignancies. Materials and methods. Thirty-seven patients (ten healthy volunteers and 27 patients with suspected renal malignancy) underwent T1-, T2-weighted and T1-weighted contrast-enhanced magnetic resonance imaging (MRI). Diffusion-weighted images were obtained with a single-shot spin-echo echo-planar imaging (SE-EPI) sequence with a b value of 500 S/mm(2). All lesions were surgically resected, and mean tumour cellularity was calculated. Comparison between tumour cellularity and mean ADC value was performed using simple linear regression analysis. Results. The mean ADC value in normal renal parenchyma was 2.35 +/- 0.31 x 10(-3) mm(2)/S, whereas mean ADC value in renal malignancies was 1.72 +/- 0.21x10(-3) mm(2)/S. In our population, there were no statistically significant differences between ADC values of different histological types. The analysis of mean ADC values showed an inverse linear correlation with cellularity in renal malignancies (r=0.73, p<0.01). Conclusions. DW-MRI is able to differentiate between normal and neoplastic renal parenchyma on the basis of tissue cellularity.