Cargando…
Use of quantitative T2 mapping for the assessment of renal cell carcinomas: first results
BACKGROUND: Correct staging and grading of patients with clear cell renal cell carcinoma (cRCC) is of clinical relevance for the prediction of operability and for individualized patient management. As partial or radial resection with postoperative tumor grading currently remain the methods of choice...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555952/ https://www.ncbi.nlm.nih.gov/pubmed/31174616 http://dx.doi.org/10.1186/s40644-019-0222-8 |
_version_ | 1783425243189084160 |
---|---|
author | Adams, Lisa C. Bressem, Keno K. Jurmeister, Phillipp Fahlenkamp, Ute L. Ralla, Bernhard Engel, Guenther Hamm, Bernd Busch, Jonas Makowski, Marcus R. |
author_facet | Adams, Lisa C. Bressem, Keno K. Jurmeister, Phillipp Fahlenkamp, Ute L. Ralla, Bernhard Engel, Guenther Hamm, Bernd Busch, Jonas Makowski, Marcus R. |
author_sort | Adams, Lisa C. |
collection | PubMed |
description | BACKGROUND: Correct staging and grading of patients with clear cell renal cell carcinoma (cRCC) is of clinical relevance for the prediction of operability and for individualized patient management. As partial or radial resection with postoperative tumor grading currently remain the methods of choice for the classification of cRCC, non-invasive preoperative alternatives to differentiate lower grade from higher grade cRCC would be beneficial. METHODS: This institutional-review-board approved cross-sectional study included twenty-seven patients (8 women, mean age ± SD, 61.3 ± 14.2) with histopathologically confirmed cRCC, graded according to the International Society of Urological Pathology (ISUP). A native, balanced steady-state free precession T2 mapping sequence (TrueFISP) was performed at 1.5 T. Quantitative T2 values were measured with circular 2D ROIs in the solid tumor portion and also in the normal renal parenchyma (cortex and medulla). To estimate the optimal cut-off T2 value for identifying lower grade cRCC, a Receiver Operating Characteristic Curve (ROC) analysis was performed and sensitivity and specificity were calculated. Students’ t-tests were used to evaluate the differences in mean values for continuous variables, while intergroup differences were tested for significance with two-tailed Mann-Whitney-U tests. RESULTS: There were significant differences between the T2 values for lower grade (ISUP 1–2) and higher grade (ISUP 3–4) cRCC (p < 0.001), with higher T2 values for lower grade cRCC compared to higher grade cRCC. The sensitivity and specificity for the differentiation of lower grade from higher grade tumors were 83.3% (95% CI: 0.59–0.96) and 88.9% (95% CI: 0.52–1.00), respectively, using a threshold value of ≥110 ms. Intraobserver/interobserver agreement for T2 measurements was excellent/substantial. CONCLUSIONS: Native T2 mapping based on a balanced steady-state free precession MR sequence might support an image-based distinction between lower and higher grade cRCC in a two-tier-system and could be a helpful addition to multiparametric imaging. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40644-019-0222-8) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6555952 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-65559522019-06-10 Use of quantitative T2 mapping for the assessment of renal cell carcinomas: first results Adams, Lisa C. Bressem, Keno K. Jurmeister, Phillipp Fahlenkamp, Ute L. Ralla, Bernhard Engel, Guenther Hamm, Bernd Busch, Jonas Makowski, Marcus R. Cancer Imaging Research Article BACKGROUND: Correct staging and grading of patients with clear cell renal cell carcinoma (cRCC) is of clinical relevance for the prediction of operability and for individualized patient management. As partial or radial resection with postoperative tumor grading currently remain the methods of choice for the classification of cRCC, non-invasive preoperative alternatives to differentiate lower grade from higher grade cRCC would be beneficial. METHODS: This institutional-review-board approved cross-sectional study included twenty-seven patients (8 women, mean age ± SD, 61.3 ± 14.2) with histopathologically confirmed cRCC, graded according to the International Society of Urological Pathology (ISUP). A native, balanced steady-state free precession T2 mapping sequence (TrueFISP) was performed at 1.5 T. Quantitative T2 values were measured with circular 2D ROIs in the solid tumor portion and also in the normal renal parenchyma (cortex and medulla). To estimate the optimal cut-off T2 value for identifying lower grade cRCC, a Receiver Operating Characteristic Curve (ROC) analysis was performed and sensitivity and specificity were calculated. Students’ t-tests were used to evaluate the differences in mean values for continuous variables, while intergroup differences were tested for significance with two-tailed Mann-Whitney-U tests. RESULTS: There were significant differences between the T2 values for lower grade (ISUP 1–2) and higher grade (ISUP 3–4) cRCC (p < 0.001), with higher T2 values for lower grade cRCC compared to higher grade cRCC. The sensitivity and specificity for the differentiation of lower grade from higher grade tumors were 83.3% (95% CI: 0.59–0.96) and 88.9% (95% CI: 0.52–1.00), respectively, using a threshold value of ≥110 ms. Intraobserver/interobserver agreement for T2 measurements was excellent/substantial. CONCLUSIONS: Native T2 mapping based on a balanced steady-state free precession MR sequence might support an image-based distinction between lower and higher grade cRCC in a two-tier-system and could be a helpful addition to multiparametric imaging. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40644-019-0222-8) contains supplementary material, which is available to authorized users. BioMed Central 2019-06-07 /pmc/articles/PMC6555952/ /pubmed/31174616 http://dx.doi.org/10.1186/s40644-019-0222-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Adams, Lisa C. Bressem, Keno K. Jurmeister, Phillipp Fahlenkamp, Ute L. Ralla, Bernhard Engel, Guenther Hamm, Bernd Busch, Jonas Makowski, Marcus R. Use of quantitative T2 mapping for the assessment of renal cell carcinomas: first results |
title | Use of quantitative T2 mapping for the assessment of renal cell carcinomas: first results |
title_full | Use of quantitative T2 mapping for the assessment of renal cell carcinomas: first results |
title_fullStr | Use of quantitative T2 mapping for the assessment of renal cell carcinomas: first results |
title_full_unstemmed | Use of quantitative T2 mapping for the assessment of renal cell carcinomas: first results |
title_short | Use of quantitative T2 mapping for the assessment of renal cell carcinomas: first results |
title_sort | use of quantitative t2 mapping for the assessment of renal cell carcinomas: first results |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555952/ https://www.ncbi.nlm.nih.gov/pubmed/31174616 http://dx.doi.org/10.1186/s40644-019-0222-8 |
work_keys_str_mv | AT adamslisac useofquantitativet2mappingfortheassessmentofrenalcellcarcinomasfirstresults AT bressemkenok useofquantitativet2mappingfortheassessmentofrenalcellcarcinomasfirstresults AT jurmeisterphillipp useofquantitativet2mappingfortheassessmentofrenalcellcarcinomasfirstresults AT fahlenkamputel useofquantitativet2mappingfortheassessmentofrenalcellcarcinomasfirstresults AT rallabernhard useofquantitativet2mappingfortheassessmentofrenalcellcarcinomasfirstresults AT engelguenther useofquantitativet2mappingfortheassessmentofrenalcellcarcinomasfirstresults AT hammbernd useofquantitativet2mappingfortheassessmentofrenalcellcarcinomasfirstresults AT buschjonas useofquantitativet2mappingfortheassessmentofrenalcellcarcinomasfirstresults AT makowskimarcusr useofquantitativet2mappingfortheassessmentofrenalcellcarcinomasfirstresults |