肾细胞癌患者实性和易碎肿瘤血栓的鉴别：磁共振成像表观弥散系数的作用。

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences Pub Date : 2024-09-01 DOI:10.1016/j.advms.2024.09.002

Paweł Kowal , Krzysztof Ratajczyk , Wiktor Bursiewicz , Maciej Trzciniecki , Karolina Marek-Bukowiec , Joanna Rogala , Vasyl Kowalskyi , Jozef Dragasek , Andrea Botikova , Peter Kruzliak , Yulian Mytsyk

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引用次数: 0

摘要

目的：肾细胞癌（RCC）累及下腔静脉（IVC）与较高的疾病分期有关，被认为是预后不良的危险因素。本研究旨在探讨磁共振成像三维纹理分析的表观扩散系数（ADC）在区分RCC患者实性和易碎肿瘤血栓中的作用：该研究涉及27名肾静脉或IVC内有肿瘤血栓的RCC患者，他们均接受了肾切除术和血栓切除术，术前进行了腹部磁共振成像（包括DWI序列）。在进行三维纹理分析时，使用了 ADC 图，并根据血栓的整个体积计算了一阶放射学特征。所有肿瘤血栓在组织学上分为实性和易碎两种：结果：51.9%和48.1%的患者分别发现了实性和易碎血栓。各组间的平均值范围、第90百分位数、四分位间范围、峰度、均匀度和方差均无差异。在区分实性和易碎肿瘤血栓方面，ADC 平均值、中位数和熵的敏感性和特异性相同（分别为 93% 和 69%），其中熵的 AUC 最高（0.808）。应用0.09的偏度阈值使我们的灵敏度达到86%，特异度达到92%：结论：对于肾静脉或内静脉中存在肿瘤血栓的RCC患者，基于ADC图的三维纹理分析可精确区分实体和易碎血栓。

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Differentiation of solid and friable tumour thrombus in patients with renal cell carcinoma: The role of MRI apparent diffusion coefficient

Purpose

Inferior vena cava (IVC) involvement by renal cell carcinoma (RCC) is associated with a higher disease stage and is considered a risk factor for poor prognosis. This study aimed to investigate the role of the apparent diffusion coefficient (ADC) of MRI 3D texture analysis in the differentiation of solid and friable tumour thrombus in patients with RCC.

Materials and methods

The study involved 27 patients with RCC with tumour thrombus in the renal vein or IVC, surgically treated with nephrectomy and thrombectomy and in whom preoperatively abdominal MRI including the DWI sequence was conducted. For 3D texture analysis, the ADC map was used, and the first-order radiomic features were calculated from the whole volume of the thrombus. All tumour thrombi were histologically classified as solid or friable.

Results

The solid and friable thrombus was detected in 51.9 % and 48.1 % of patients, respectively. No differences in mean values of range, 90th percentile, interquartile range, kurtosis, uniformity and variance were found between groups. Equal sensitivity and specificity (93 % and 69 %, respectively) of ADC mean, median and entropy in differentiation between solid and friable tumour thrombus, with the highest AUC for entropy (0.808), were observed. Applying the skewness threshold value of 0.09 allowed us to achieve a sensitivity of 86 % and a specificity of 92 %.

Conclusions

In patients with RCC and tumour thrombus in the renal vein or IVC, the 3D texture analysis based on ADC-map allows for precise differentiation of a solid from a friable thrombus.

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来源期刊

Advances in medical sciences 医学-医学：研究与实验

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

25 days

期刊介绍： Advances in Medical Sciences is an international, peer-reviewed journal that welcomes original research articles and reviews on current advances in life sciences, preclinical and clinical medicine, and related disciplines. The Journal’s primary aim is to make every effort to contribute to progress in medical sciences. The strive is to bridge laboratory and clinical settings with cutting edge research findings and new developments. Advances in Medical Sciences publishes articles which bring novel insights into diagnostic and molecular imaging, offering essential prior knowledge for diagnosis and treatment indispensable in all areas of medical sciences. It also publishes articles on pathological sciences giving foundation knowledge on the overall study of human diseases. Through its publications Advances in Medical Sciences also stresses the importance of pharmaceutical sciences as a rapidly and ever expanding area of research on drug design, development, action and evaluation contributing significantly to a variety of scientific disciplines. The journal welcomes submissions from the following disciplines: General and internal medicine, Cancer research, Genetics, Endocrinology, Gastroenterology, Cardiology and Cardiovascular Medicine, Immunology and Allergy, Pathology and Forensic Medicine, Cell and molecular Biology, Haematology, Biochemistry, Clinical and Experimental Pathology.