Renal clear cell carcinoma: diffusion tensor imaging diagnostic accuracy and correlations with clinical and histopathological factors

AIM: To investigate whether diffusion tensor imaging (DTI) can be used to assess renal clinical histopathology, including the nuclear grade (NG), cell density (CD), and the presence of ki-67. MATERIALS AND METHODS: Thirty patients were enrolled in the study and were confirmed at surgical histopathology to have clear cell renal cell carcinoma (CCRCC). For DTI, a coronal echo-planar imaging sequence was performed (1400 ms repetition time, 76 ms echo time, diffusion direction=6, number of excitations=4; b=0 and 800 s/mm(2), 6 mm section thickness with no intersection gap). CD and the presence of ki-67 were compared between the different NGs. Correlations between apparent diffusion coefficients (ADCs), E1, fractional anisotropy (FA), CD, and ki-67 were evaluated. RESULTS: ADC, E1, and FA values are important tools used to identify NG. The cut-off values were 1.003x10(-3) mm(2)/s, 1.277x10(-3) mm(2)/s, and 0.218 mm(2)/s, respectively. The difference between high-and low-grade CD was significant (t=-4.50, p<0.05). Similarly, a significant difference between high and low grade was also found in ki-67 (t=-4.03, p<0.05). ADC, E1, and FA values were decreased with increased CD; a significant negative correlation was found (r=-0.796, -0.865, and -0.996, respectively). Significant negative correlations between ADC, E1, and FA values, and ki-67 were found (r=-0.739, -0.826, and -0.876, respectively). CONCLUSIONS: DTI can be used to non-invasively assess CCRCC. (C) 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.