Journal
CANCER IMAGING
Volume 19, Issue -, Pages -Publisher
BMC
DOI: 10.1186/s40644-019-0222-8
Keywords
MRI mapping techniques; Quantitative MRI; T2 mapping; Clear cell renal cell carcinoma; Tumor grading
Funding
- Abbott
- Actelion Pharmaceuticals
- Bayer Schering Pharma
- Bayer Vital
- BRACCO Group
- Bristol-Myers Squibb
- Charite research organisation GmbH
- Deutsche Krebshilfe
- Dt. Stiftung fur Herzforschung
- Essex Pharma
- Fibrex Medical Inc.
- Focused Ultrasound Surgery Foundation
- Fraunhofer Gesellschaft
- Guerbet
- InSightec Ud.
- IPSEN Pharma
- Kendlel MorphoSys AG
- Lilly GmbH
- Lundbeck GmbH
- MeVis Medical Solutions AG
- Nexus Oncology
- Novartis
- Parexel Clinical Research Organisation Service
- Perceptive
- Pfizer GmbH
- Philipps
- SanofisAventis S. A
- Siemens
- Spectranetics GmbH
- Terumo Medical Corporation
- TNS Healthcare GMbH
- Toshiba
- UCB Pharma
- Wyeth Pharma
- Zukunftsfond Berlin (TSB)
- Amgen
- AO Foundation
- BARD
- BBraun
- Boehring Ingelheimer
- Brainsgate
- PPD (Clinical Research Organisation)
- CELLACT Pharma
- Celgene
- CeloNova BioSciences
- Covance
- Deviees, Ine. USA
- Ganymed
- Gilead Sciences
- Glaxo Smith Kline
- ICON (Clinical Research Organisation)
- Jansen
- LUX Bioseienees
- MedPass
- Merek
- Mologen
- Nuvisan
- Pluristem
- Quintiles
- Roehe
- Sehumaeher GmbH
- Seattle Geneties
- Symphogen
- TauRx Therapeuties Ud.
- Accovion
- AIO: Arbeitsgemeinschaft Internistische Onkologie
- ASR Advanced sleep research
- Astellas
- Theradex
- Galena Biopharma
- Chiltern
- PRAint
- Inspiremd
- Medronic
- Respicardia
- Silena Therapeutics
- Spectrum Pharmaceuticals
- St. Jude.
- TEVA
- Theorem
- Abbvie
- Aesculap
- Biotronik
- Inventivhealth
- ISA Therapeutics
- LYSARC
- MSD
- novocure
- Ockham oncology
- Premier-research
- Psi-cro
- Tetec-ag
- Winickernorimed
- Achaogen Inc.
- ADIR
- AstraZenaca AB
- Demira Inc.
- Euroscreen S. A.
- Galmed Research and Development Ltd.
- GETNE
- Guidant Europe NV
- Holaira Inc.
- Immunomedics Inc.
- Innate Pharma
- Isis Pharmaceuticals Inc.
- Kantar Health GmbH
- MedImmune Inc.
- Medpace Germany GmbH (CRO)
- Merrimack Pharmaceuticals Inc.
- Millenium Pharmaceuticals Inc.
- Orion Corporation Orion Pharma
- Pharmacyclics Inc.
- PIQUR Therapeutics Ltd.
- Pulmonx International Sarl
- Servier (CRO)
- SGS Life Science Services (CRO)
- Treshold Pharmaceuticals Inc.
- Deutsche Forschungsgemeinschaft (DFG) [SFB 1340/1 2018, 5943/31/41/91]
- Charite - Universitaetsmedizin Berlin
- Berlin Institute of Health
- EU Programmes
- INC Research
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BackgroundCorrect staging and grading of patients with clear cell renal cell carcinoma (cRCC) is of clinical relevance for the prediction of operability and for individualized patient management. As partial or radial resection with postoperative tumor grading currently remain the methods of choice for the classification of cRCC, non-invasive preoperative alternatives to differentiate lower grade from higher grade cRCC would be beneficial.MethodsThis institutional-review-board approved cross-sectional study included twenty-seven patients (8 women, mean ageSD, 61.314.2) with histopathologically confirmed cRCC, graded according to the International Society of Urological Pathology (ISUP). A native, balanced steady-state free precession T2 mapping sequence (TrueFISP) was performed at 1.5T. Quantitative T2 values were measured with circular 2D ROIs in the solid tumor portion and also in the normal renal parenchyma (cortex and medulla). To estimate the optimal cut-off T2 value for identifying lower grade cRCC, a Receiver Operating Characteristic Curve (ROC) analysis was performed and sensitivity and specificity were calculated. Students' t-tests were used to evaluate the differences in mean values for continuous variables, while intergroup differences were tested for significance with two-tailed Mann-Whitney-U tests.ResultsThere were significant differences between the T2 values for lower grade (ISUP 1-2) and higher grade (ISUP 3-4) cRCC (p<0.001), with higher T2 values for lower grade cRCC compared to higher grade cRCC. The sensitivity and specificity for the differentiation of lower grade from higher grade tumors were 83.3% (95% CI: 0.59-0.96) and 88.9% (95% CI: 0.52-1.00), respectively, using a threshold value of 110ms. Intraobserver/interobserver agreement for T2 measurements was excellent/substantial.ConclusionsNative T2 mapping based on a balanced steady-state free precession MR sequence might support an image-based distinction between lower and higher grade cRCC in a two-tier-system and could be a helpful addition to multiparametric imaging.
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