scholarly journals Magnetic resonance diffusion kurtosis imaging in differential diagnosis of benign and malignant renal tumors

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jianxiong Fu ◽  
Jing Ye ◽  
Wenrong Zhu ◽  
Jingtao Wu ◽  
Wenxin Chen ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Mean Diffusivity ◽  
Threshold Value ◽  
Renal Tumors ◽  
Diffusion Kurtosis Imaging ◽  
Renal Oncocytoma ◽  
Renal Angiomyolipoma ◽  
Planar Imaging ◽  
Cell Renal Cell Carcinoma ◽  
Diffusion Kurtosis

Abstract Background Benign and malignant renal tumors share similar some imaging findings. Methods Sixty-six patients with clear cell renal cell carcinoma (CCRCC), 13 patients with renal angiomyolipoma with minimal fat (RAMF) and 7 patients with renal oncocytoma (RO) were examined. For diffusion kurtosis imaging (DKI), respiratory triggered echo-planar imaging sequences were acquired in axial plane (3 b-values: 0, 500, 1000s/mm2). Mean Diffusivity (MD), fractional Anisotropy (FA), mean kurtosis (MK), kurtosis anisotropy (KA) and radial kurtosis (RK) were performed. Results For MD, a significant higher value was shown in CCRCC (3.08 ± 0.23) than the rest renal tumors (2.93 ± 0.30 for RO, 1.52 ± 0.24 for AML, P < 0.05). The MD values were higher for RO than for AML (2.93 ± 0.30 vs.1.52 ± 0.24, P < 0.05), while comparable MD values were found between CCRCC and RO (3.08 ± 0.23 vs. 2.93 ± 0.30, P > 0.05). For MK, KA and RK, a significant higher value was shown in AML (1.32 ± 0.16, 1.42 ± 0.23, 1.41 ± 0.29) than CCRCC (0.43 ± 0.08, 0.57 ± 0.16, 0.37 ± 0.11) and RO (0.81 ± 0.08, 0.86 ± 0.16, 0.69 ± 0.08) (P < 0.05). The MK, KA and RK values were higher for RO than for CCRCC (0.81 ± 0.08 vs. 0.43 ± 0.08, 0.86 ± 0.16 vs. 0.57 ± 0.16, 0.69 ± 0.08 vs. 0.37 ± 0.11, P < 0.05). Using MD values of 2.86 as the threshold value for differentiating CCRCC from RO and AML, the best result obtained had a sensitivity of 76.1%, specificity of 72.6%. Using MK, KA and RK values of 1.19,1.13 and 1.11 as the threshold value for differentiating AML from CCRCC and RO, the best result obtained had a sensitivity of 91.2, 86.7, 82.1%, and specificity of 86.7, 83.2, 72.8%. Conclusion DKI can be used as another noninvasive biomarker for benign and malignant renal tumors’ differential diagnosis.

scholarly journals Value of radiomics in differential diagnosis of chromophobe renal cell carcinoma and renal oncocytoma

2019 ◽  
Vol 45 (10) ◽  
pp. 3193-3201 ◽  
Author(s):  
Yajuan Li ◽  
Xialing Huang ◽  
Yuwei Xia ◽  
Liling Long
Keyword(s):  
Machine Learning ◽  
Differential Diagnosis ◽  
Cell Carcinoma ◽  
Area Under The Curve ◽  
Image Features ◽  
Renal Tumors ◽  
Support Vector ◽  
Svm Classifier ◽  
Renal Oncocytoma ◽  
Lasso Regression

Abstract Purpose To explore the value of CT-enhanced quantitative features combined with machine learning for differential diagnosis of renal chromophobe cell carcinoma (chRCC) and renal oncocytoma (RO). Methods Sixty-one cases of renal tumors (chRCC = 44; RO = 17) that were pathologically confirmed at our hospital between 2008 and 2018 were retrospectively analyzed. All patients had undergone preoperative enhanced CT scans including the corticomedullary (CMP), nephrographic (NP), and excretory phases (EP) of contrast enhancement. Volumes of interest (VOIs), including lesions on the images, were manually delineated using the RadCloud platform. A LASSO regression algorithm was used to screen the image features extracted from all VOIs. Five machine learning classifications were trained to distinguish chRCC from RO by using a fivefold cross-validation strategy. The performance of the classifier was mainly evaluated by areas under the receiver operating characteristic (ROC) curve and accuracy. Results In total, 1029 features were extracted from CMP, NP, and EP. The LASSO regression algorithm was used to screen out the four, four, and six best features, respectively, and eight features were selected when CMP and NP were combined. All five classifiers had good diagnostic performance, with area under the curve (AUC) values greater than 0.850, and support vector machine (SVM) classifier showed a diagnostic accuracy of 0.945 (AUC 0.964 ± 0.054; sensitivity 0.999; specificity 0.800), showing the best performance. Conclusions Accurate preoperative differential diagnosis of chRCC and RO can be facilitated by a combination of CT-enhanced quantitative features and machine learning.

scholarly journals Differential Diagnosis of Renal Tumors With Clear Cytoplasm: Clinical Relevance of Renal Tumor Subclassification in the Era of Targeted Therapies and Personalized Medicine

2013 ◽  
Vol 137 (4) ◽  
pp. 467-480 ◽  
Author(s):  
Rajen Goyal ◽  
Elizabeth Gersbach ◽  
Ximing J. Yang ◽  
Stephen M. Rohan
Keyword(s):  
Renal Cell Carcinoma ◽  
Differential Diagnosis ◽  
Cell Carcinoma ◽  
Targeted Therapies ◽  
Renal Cell ◽  
Clear Cell ◽  
Renal Tumor ◽  
Renal Tumors ◽  
Cell Renal Cell Carcinoma ◽  
Immunohistochemical Stains

Context.—The World Health Organization classification of renal tumors synthesizes morphologic, immunohistochemical, and molecular findings to define more than 40 tumor types. Of these, clear cell (conventional) renal cell carcinoma is the most common malignant tumor in adults and—with the exception of some rare tumors—the most deadly. The diagnosis of clear cell renal cell carcinoma on morphologic grounds alone is generally straightforward, but challenging cases are not infrequent. A misdiagnosis of clear cell renal cell carcinoma has clinical consequences, particularly in the current era of targeted therapies. Objective.—To highlight morphologic mimics of clear cell renal cell carcinoma and provide strategies to help differentiate clear cell renal cell carcinoma from other renal tumors and lesions. The role of the pathologist in guiding treatment for renal malignancies will be emphasized to stress the importance of proper tumor classification in patient management. Data Sources.—Published literature and personal experience. Conclusions.—In challenging cases, submission of additional tissue is often an inexpensive and effective way to facilitate a correct diagnosis. If immunohistochemical stains are to be used, it is best to use a panel of markers, as no one marker is specific for a given renal tumor subtype. Selection of limited markers, based on a specific differential diagnosis, can be as useful as a large panel in reaching a definitive diagnosis. For renal tumors, both the presence and absence of immunoreactivity and the pattern of labeling (membranous, cytoplasmic, diffuse, focal) are important when interpreting the results of immunohistochemical stains.

Vimentin Reactivity in Renal Oncocytoma: Immunohistochemical Study of 234 Cases

2007 ◽  
Vol 131 (12) ◽  
pp. 1782-1788 ◽  
Author(s):  
Ondrej Hes ◽  
Michal Michal ◽  
Naoto Kuroda ◽  
Guido Martignoni ◽  
Matteo Brunelli ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Renal Cell ◽  
Imaging System ◽  
Large Series ◽  
Renal Tumors ◽  
Renal Oncocytoma ◽  
Renal Cell Carcinomas ◽  
Central Scar ◽  
Renal Oncocytomas ◽  
The Difference

Abstract Context.—The expression of vimentin in benign renal oncocytomas has been controversal. However, this is of clinical significance because immunostains may be used in differential diagnosis of renal tumors on limited biopsy specimens. Using different staining and analysis methods, we studied vimentin immunoreactivity in a large series of renal oncocytomas with a special emphasis on the immunoreactivity patterns. Objective.—Immunohistochemical expression of vimentin has been used in the differential diagnosis of renal epithelial neoplasms. Although typically expressed in most renal cell carcinomas, the immunoreactivity of this intermediate filament in renal oncocytomas has been controversial. Design.—We studied vimentin immunoreactivity in a large series of 234 renal oncocytomas using 2 staining methods as well as manual and automated imaging analyses. Results.—We found that the focal vimentin immunoreactivity can be seen in most (72.6%) renal oncocytomas with vimentin-positive tumor cells usually found in the edge of a central scar or in small clusters scattered throughout the tumor. Computer-aided imaging analysis using ChromaVision Automatic Cellular Imaging System II confirmed the difference in vimentin immunoreactivity between oncocytoma and other renal neoplasms. Conclusions.—Our study of vimentin immunohistochemistry in a series of renal oncocytomas, which to our knowledge is the largest ever published, showed focal vimentin positivity detected in most oncocytomas. Because the vimentin staining patterns in renal oncocytomas are different from those seen in clear cell or papillary renal cell carcinomas, we consider vimentin staining to be helpful in the differential diagnosis of oncocytoma from other renal tumor mimics. Furthermore, strong vimentin positivity in a renal cell neoplasm does not exclude the diagnosis of renal oncocytoma, particularly in a limited biopsy specimen.

scholarly journals Differential diagnosis of <3 cm renal tumors by ultrasonography: a rapid, quantitative, elastography self-corrected contrast-enhanced ultrasound imaging mode beyond screening

2020 ◽  
Vol 93 (1112) ◽  
pp. 20190974
Author(s):  
Di Sun ◽  
Qijie Lu ◽  
Cong Wei ◽  
Yi Li ◽  
Yuanyi Zheng ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Ultrasound Imaging ◽  
Screening Method ◽  
Acoustic Radiation Force Impulse ◽  
Renal Tumors ◽  
Diagnostic Strategy ◽  
Contrast Enhanced Ultrasound ◽  
Cell Renal Cell Carcinoma ◽  
Contrast Enhanced ◽  
Imaging Mode

Objectives: To assess the combined diagnostic strategy of contrast-enhanced ultrasound (CEUS) and acoustic radiation force impulse (ARFI) in the precise differential diagnosis of clear cell renal cell carcinoma (CCRCC) and urothelium carcinoma of the renal pelvis (UCRP) with other small renal tumors (SRTs) ＜3 cm in size. Methods: The elastography self-corrected CEUS (ESC) mode was established to perform the quantitative differential diagnosis of SRTs (<3 cm). The kidney shear wave velocity (SWV) value recorded by ARFI showed substantial variability in patients with CCRCC (high elasticity value) and UCRP (low elasticity value) compared with other renal masses, thus providing critical self-correction information for the ultrasound differential diagnosis of SRTs. Results: In this work, the ESC observations and the corresponding ESC criteria show a remarkable 94.6% accuracy in reference to the gold standards, thus allowing the quantitative, early triple distinction of CCRCC with UCRP and other SRTs in patients with suspicious SRTs. Conclusions: This ARFI self-corrected CEUS diagnostic strategy is far beyond a screening method and may have the potential to identify a window of therapeutic opportunity in which emerging therapies might be applied to patients with CCRCC and UCRP, reducing overtreatment and medical costs. Advances in knowledge: In our study, a new rapid and non-invasive elastography self-corrected CEUS (ESC) ultrasound imaging mode was developed, which was useful in the triple distinction of CCRCC, UCRP, and other SRTs with 94.6% accuracy. ESC is a promising method in the differential diagnosis of SRTs with accuracy and practicability far beyond a single screening model.

scholarly journals Diffusion Kurtosis Imaging as a Prognostic Marker in Osteosarcoma Patients with Preoperative Chemotherapy

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Chenglei Liu ◽  
Yue Xing ◽  
Dongmin Wei ◽  
Qiong Jiao ◽  
Qingcheng Yang ◽  
...  
Keyword(s):  
Preoperative Chemotherapy ◽  
Tumor Resection ◽  
Mean Diffusivity ◽  
Cox Proportional Hazards ◽  
Diffusion Kurtosis Imaging ◽  
Rank Test ◽  
Poor Responders ◽  
Risk Of Death ◽  
Increased Risk ◽  
Diffusion Kurtosis

Background. The accurate prediction of prognosis is key to prompt therapy adjustment. The purpose of our study was to investigate the efficacy of diffusion kurtosis imaging (DKI) in predicting progression-free survival (PFS) and overall survival (OS) in osteosarcoma patients with preoperative chemotherapy. Methods. Thirty patients who underwent DKI before and after chemotherapy, followed by tumor resection, were retrospectively enrolled. The patients were grouped into good responders (GRs) and poor responders (PRs). The Kaplan-Meier and log-rank test were used for survival analysis. The association between the DKI parameters and OS and PFS was performed by univariate and multivariate Cox proportional hazards models. Results. Significantly worse OS and PFS were associated with a lower mean diffusivity (MD) after chemotherapy (HR, 5.8; 95% CI, 1.5-23.1; P=0.012 and HR, 3.5; 95% CI, 1.2-10.1: P=0.028, respectively) and a higher mean kurtosis (MK) after chemotherapy (HR, 0.3; 95% CI, 0.1-0.9; P=0.041 and HR, 0.3; 95% CI, 0.1-0.8; P=0.049, respectively). Likewise, shorter OS and PFS were also significantly associated with a change rate in MD (CR MD) of less than 13.53% (HR, 8.6; 95% CI, 1.8-41.8; P=0.007 and HR, 2.9; 95% CI, 1.0-8.2; P=0.045, respectively). Compared to GRs, PRs had an approximately 9- and 4-fold increased risk of death (HR, 9.4; 95% CI, 1.2-75; P=0.034) and progression (HR, 4.2; 95% CI, 1.2-15; P=0.026), respectively. Conclusions. DKI has a potential to be a prognostic tool in osteosarcoma. Low MK and high MD after chemotherapy or high CR MD indicates favorite outcome, while prospective studies with large sample sizes are warranted.

scholarly journals The Value of Diffusion Kurtosis Imaging In Detecting Delayed Brain Development of Premature Infants

2021 ◽  
Author(s):  
Xin Zhao ◽  
Chunxiang Zhang ◽  
Bohao Zhang ◽  
Jiayue Yan ◽  
Kaiyu Wang ◽  
...  
Keyword(s):  
White Matter ◽  
Caudate Nucleus ◽  
Premature Infants ◽  
Developmental Disorders ◽  
Neurodevelopmental Outcome ◽  
Mean Diffusivity ◽  
Internal Capsule ◽  
Diffusion Kurtosis Imaging ◽  
Control Group ◽  
Diffusion Kurtosis

Abstract Objective Preterm infants are at high risk of adverse neurodevelopmental outcome. Our aim is to explore the value of diffusion kurtosis imaging (DKI) in diagnosing brain developmental disorders in premature infants.Materials and Methods A total of 52 subjects were included in this study, including 26 premature infants as the preterm group, and 26 full-term infants as the control group. Routine magnetic resonance imaging and DKI examination were performed. Mean kurtosis (MK), radial kurtosis (RK), fractional anisotropy (FA), mean diffusivity (MD) values were measured in the brain regions including posterior limbs of the internal capsule (PLIC); anterior limb of internal capsule (ALIC); parietal white matter (PWM); frontal white matter (FWM); thalamus (TH); caudate nucleus (CN); genu of the corpus callosum (GCC). The X2, t test, Spearman’s correlation analysis and receiver operating characteristic curve (ROC)were used for data analyses.Results In the premature infant group, the MK and RK values of PLIA, ALIC, and PWM were lower than those in the control group (P<0.05). The FA values of PWM, FWM and TH were also lower than those of the control group (P<0.05). The AUCs of MK in PLIC and ALIC, MD in PWM, and FA in FWM were 0.813, 0.802, 0.842 and 0.867 (P<0.05). In thalamus and caudate nucleus, the correlations between MK, RK values and PMA were higher than those between FA, MD values and PMA.Conclusions DKI can be used as an effective tool in detecting brain developmental disorders in premature infants.

Histogram analysis in prostate cancer: a comparison of diffusion kurtosis imaging model versus monoexponential model

2020 ◽  
Vol 61 (10) ◽  
pp. 1431-1440
Author(s):  
Yuwei Jiang ◽  
Chunmei Li ◽  
Ying Liu ◽  
Kaining Shi ◽  
Wei Zhang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Histogram Analysis ◽  
Diffusion Kurtosis Imaging ◽  
Single Shot ◽  
Diagnostic Efficiency ◽  
Planar Imaging ◽  
Significant Difference ◽  
Monoexponential Model ◽  
The Mean ◽  
Diffusion Kurtosis

Background There is still little research about histogram analysis of diffusion kurtosis imaging (DKI) using in prostate cancer at present. Purpose To verify the utility of histogram analysis of DKI model in detection and assessment of aggressiveness of prostate cancer, compared with monoexponential model (MEM). Material and Methods Twenty-three patients were enrolled in this study. For DKI model and MEM, the Dapp, Kapp, and apparent diffusion coefficient (ADC) were obtained by using single-shot echo-planar imaging sequence. The pathologies were confirmed by in-bore magnetic resonance (MR)-guided biopsy. Regions of interest (ROI) were drawn manually in the position where biopsy needle was put. The mean values and histogram parameters in cancer and noncancerous foci were compared using independent-samples T test. Receiver operating characteristic curves were used to investigate the diagnostic efficiency. Spearman’s test was used to evaluate the correlation of parameters and Gleason scores. Results The mean, 10th, 25th, 50th, 75th, and 90th percentiles of ADC and Dapp were significantly lower in prostate cancer than non-cancerous foci ( P < 0.001). The mean, 50th, 75th, and 90th percentiles of Kapp were significantly higher in prostate cancer ( P < 0.05). There was no significant difference between the AUCs of two models (0.971 vs. 0.963, P > 0.05). With the increasing Gleason scores, the 10th ADC decreased ( ρ = −0.583, P = 0.018), but the 90th Kapp increased ( ρ = 0.642, P = 0.007). Conclusion Histogram analysis of DKI model is feasible for diagnosing and grading prostate cancer, but it has no significant advantage over MEM.

scholarly journals Diffusion Kurtosis Imaging Detects Microstructural Changes in the Brain after Acute Alcohol Intoxication in Rats

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Xi-ran Chen ◽  
Jie-ying Zeng ◽  
Zhi-Wei Shen ◽  
Ling-mei Kong ◽  
Wen-bin Zheng
Keyword(s):  
Frontal Lobe ◽  
Diffusion Tensor ◽  
Alcohol Intoxication ◽  
Mean Diffusivity ◽  
Diffusion Kurtosis Imaging ◽  
Acute Alcohol Intoxication ◽  
Additional Information ◽  
Diffusion Kurtosis ◽  
The Brain ◽  
Acute Intake

The aim of this study was to test the technical feasibility of diffusion kurtosis imaging (DKI) in the brain after acute alcohol intoxication. Diffusion tensor imaging (DTI) and DKI during 7.0 T MRI were performed in the frontal lobe and thalamus before and 30 min, 2 h, and 6 h after ethyl alcohol administration. Compared with controls, mean kurtosis values of the frontal lobe and thalamus first decreased by 44% and 38% within 30 min (p<0.01 all) and then increased by 14% and 46% at 2 h (frontal lobe, p>0.05; thalamus, p<0.01) and by 29% and 68% at 6 h (frontal lobe, p<0.05; thalamus, p<0.01) after acute intake. Mean diffusivity decreased significantly in both the frontal lobe and the thalamus at various stages. However, fractional anisotropy decreased only in the frontal lobe, with no detectable change in the thalamus. This demonstrates that DKI possesses sufficient sensitivity for tracking pathophysiological changes at various stages associated with acute alcohol intoxication and may provide additional information that may be missed by conventional DTI parameters.

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