Journal
EUROPEAN RADIOLOGY
Volume 27, Issue 5, Pages 2146-2152Publisher
SPRINGER
DOI: 10.1007/s00330-016-4549-2
Keywords
Bladder malignancy; Tumour heterogeneity; Apparent Diffusion Coefficient; Histogram analysis; K-means clustering
Funding
- NCI NIH HHS [P30 CA016058] Funding Source: Medline
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To quantify the heterogeneity of the tumour apparent diffusion coefficient (ADC) using voxel-based analysis to differentiate malignancy from benign wall thickening of the urinary bladder. Nineteen patients with histopathological findings of their cystectomy specimen were included. A data set of voxel-based ADC values was acquired for each patient's lesion. Histogram analysis was performed on each data set to calculate uniformity (U) and entropy (E). The k-means clustering of the voxel-wised ADC data set was implemented to measure mean intra-cluster distance (MICD) and largest inter-cluster distance (LICD). Subsequently, U, E, MICD, and LICD for malignant tumours were compared with those for benign lesions using a two-sample t-test. Eleven patients had pathological confirmation of malignancy and eight with benign wall thickening. Histogram analysis showed that malignant tumours had a significantly higher degree of ADC heterogeneity with lower U (P = 0.016) and higher E (P = 0.005) than benign lesions. In agreement with these findings, k-means clustering of voxel-wise ADC indicated that bladder malignancy presented with significantly higher MICD (P < 0.001) and higher LICD (P = 0.002) than benign wall thickening. The quantitative assessment of tumour diffusion heterogeneity using voxel-based ADC analysis has the potential to become a non-invasive tool to distinguish malignant from benign tissues of urinary bladder cancer. aEuro cent Heterogeneity is an intrinsic characteristic of tumoral tissue. aEuro cent Non-invasive quantification of tumour heterogeneity can provide adjunctive information to improve cancer diagnosis accuracy. aEuro cent Histogram analysis and k-means clustering can quantify tumour diffusion heterogeneity. aEuro cent The quantification helps differentiate malignant from benign urinary bladder tissue.
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