Assessment of the extracellular volume fraction for the grading of clear cell renal cell carcinoma: first results and histopathological findings.
Objectives: To assess the potential of T1 mapping-based extracellular volume fraction (ECV) for the identification of higher grade clear cell renal cell carcinoma (cRCC), based on histopathology as the reference standard.Methods: For this single-center, institutional review board-approved prospectiv...
| Publicado en: | European Radiology Vol. 29; no. 11; pp. 5832 - 5844 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | diagnostic images pictorial research tables/charts Journal Article |
| Publicado: |
Springer Nature
Nov2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139163638&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139163638 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Nov2019 vid: 29 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 139163638 139163638 144002965 NLM30887194 139163638 10.1007/s00330-019-06087-x NLM30887194 139163638 ppf: 5832 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Assessment of the extracellular volume fraction for the grading of clear cell renal cell carcinoma: first results and histopathological findings. aug: au: Adams, Lisa C. Jurmeister, Philipp Ralla, Bernhard Bressem, Keno K. Fahlenkamp, Ute L. Engel, Guenther Siepmann, Stefan Wagner, Moritz Hamm, Bernd Busch, Jonas Makowski, Marcus R. affil: Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany sug: subj: Kidney Neoplasms Pathology Neoplasm Staging Methods Carcinoma, Renal Cell Pathology Magnetic Resonance Imaging Methods Kidney Pathology Reproducibility of Results Prospective Studies Male ROC Curve Female Middle Age Funding Source Human Middle Aged: 45-64 years Male Female ab: Objectives: To assess the potential of T1 mapping-based extracellular volume fraction (ECV) for the identification of higher grade clear cell renal cell carcinoma (cRCC), based on histopathology as the reference standard.Methods: For this single-center, institutional review board-approved prospective study, 27 patients (17 men, median age 62 ± 12.4 years) with pathologic diagnosis of cRCC (nucleolar International Society of Urological Pathology (ISUP) grading) received abdominal MRI scans at 1.5 T using a modified Look-Locker inversion recovery (MOLLI) sequence between January 2017 and June 2018. Quantitative T1 values were measured at different time points (pre- and postcontrast agent administration) and quantification of the ECV was performed on MRI and histological sections (H&E staining).Results: Reduction in T1 value after contrast agent administration and MR-derived ECV were reliable predictors for differentiating higher from lower grade cRCC. Postcontrast T1diff values (T1diff = T1 difference between the native and nephrogenic phase) and MR-derived ECV were significantly higher for higher grade cRCC (ISUP grades 3-4) compared with lower grade cRCC (ISUP grades 1-2) (p < 0.001). A cutoff value of 700 ms could distinguish higher grade from lower grade tumors with 100% (95% CI 0.69-1.00) sensitivity and 82% (95% CI 0.57-0.96) specificity. There was a positive and strong correlation between MR-derived ECV and histological ECV (p < 0.01, r = 0.88). Interobserver agreement for quantitative longitudinal relaxation times in the T1 maps was excellent.Conclusions: T1 mapping with ECV measurement could represent a novel in vivo biomarker for the classification of cRCC regarding their nucleolar grade, providing incremental diagnostic value as a quantitative MR marker.Key Points: • Reduction in MRI T1 relaxation times after contrast agent administration and MR-derived extracellular volume fraction are useful parameters for grading of clear cell renal cell carcinoma (cRCC). • T1 differences between the native and the nephrogenic phase are higher for higher grade cRCC compared with lower grade cRCC and MRI-derived extracellular volume fraction (ECV) and histological ECV show a strong correlation. • T1 mapping with ECV measurement may be helpful for the noninvasive assessment of cRCC pathology, being a safe and feasible method, and it has potential to optimize individualized treatment options, e.g., in the decision of active surveillance. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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