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Chaurasia A, Gopal N, Dehghani Firouzabadi F, Yazdian Anari P, Wakim P, Ball MW, Jones EC, Turkbey B, Huda F, Linehan WM, Turkbey EB, Malayeri AA. Role of ultra-high b-value DWI in the imaging of hereditary leiomyomatosis and renal cell carcinoma (HLRCC). Abdom Radiol (NY) 2023; 48:340-349. [PMID: 36207629 PMCID: PMC10681094 DOI: 10.1007/s00261-022-03689-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome is associated with an aggressive form of renal cell carcinoma with high risk of metastasis, even in small primary tumors with unequivocal imaging findings. In this study, we compare the performance of ultra-high b-value diffusion-weighted imaging (DWI) sequence (b = 2000 s/mm2) to standard DWI (b = 800 s/mm2) sequence in identifying malignant lesions in patients with HLRCC. METHODS Twenty-eight patients (n = 18 HLRCC patients with 22 lesions, n = 10 controls) were independently evaluated by three abdominal radiologists with different levels of experience using four combinations of MRI sequences in two separate sessions (session 1: DWI with b-800, session 2: DWI with b-2000). T1 precontrast, T2-weighted (T2WI), and apparent diffusion coefficient (ADC) sequences were similar in both sessions. Each identified lesion was subjectively assessed using a six-point cancer likelihood score based on individual sequences and overall impression. RESULTS The ability to distinguish benign versus malignant renal lesions improved with the use of b-2000 for more experienced radiologists (Reader 1 AUC: Session 1-0.649 and Session 2-0.938, p = 0.017; Reader 2 AUC: Session 1-0.781 and Session 2-0.921, p = 0.157); whereas no improvement was observed for the less experienced reader (AUC: Session 1-0.541 and Session 2-0.607, p = 0.699). CONCLUSION The inclusion of ultra-high b-value DWI sequence improved the ability of classification of renal lesions in patients with HLRCC for experienced radiologists. Consideration should be given toward incorporation of DWI with b-2000 s/mm2 into existing renal MRI protocols.
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Affiliation(s)
- Aditi Chaurasia
- Urologic Oncology Branch, National Cancer Institute (NCI), National Institutes of Health, Bethesda, MD, USA
| | - Nikhil Gopal
- Urologic Oncology Branch, National Cancer Institute (NCI), National Institutes of Health, Bethesda, MD, USA
| | - Fatemeh Dehghani Firouzabadi
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA
| | - Pouria Yazdian Anari
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA
| | - Paul Wakim
- Biostatistics and Clinical Epidemiology Service, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Mark W Ball
- Urologic Oncology Branch, National Cancer Institute (NCI), National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth C Jones
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA
| | - Baris Turkbey
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA
| | - Fahimul Huda
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA
| | - W Marston Linehan
- Urologic Oncology Branch, National Cancer Institute (NCI), National Institutes of Health, Bethesda, MD, USA
| | - Evrim B Turkbey
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA
| | - Ashkan A Malayeri
- Radiology and Imaging Sciences, Clinical Center (CC), National Institutes of Health, 10 Center Drive, 1C352, Bethesda, MD, 20892, USA.
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Ji LB, Lu ZH, Yao HH, Cao Y, Lu WW, Qian WX, Wang XM, Hu CH. [Application study of qualitatively diagnosing prostate cancer using ultrahigh b-value DWI]. Zhonghua Yi Xue Za Zhi 2017; 97:2107-2110. [PMID: 28763884 DOI: 10.3760/cma.j.issn.0376-2491.2017.27.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective: To explore the value of ultrahigh b-value DWI in diagnosis of prostate cancer. Methods: From October 2015 to October 2016, a total of 84 cases from Affiliated Changshu Hospital of Soochow University(39 cases of prostate cancer with a total of 57 lesions, 45 cases of benign prostate hyperplasia) were examined with T(2)WI, high b-value DWI (b=1 000 s/mm(2)) and ultrahigh b-value DWI (b=2 000 s/mm(2)) .Three image sets were rated respectively based on PI-RADS V2 by two radiologists and the scores were compared with biopsy results.The differences of the area under the ROC curve (AUC) among the three groups of each observer were compared by Z test. Results: The difference of AUC between ultrahigh b-value DWI and T(2)WI in the diagnosis of peripheral and transitional zone cancer was statistically significant between the two observers (P=0.009 9, 0.008 2, 0.010 8 and 0.004 5 respectively), and there was no significant difference of AUC between ultrahigh b-value DWI and high b-value DWI in the diagnosis of peripheral and transitional zone cancer.The inter-reader agreement was found to be perfect for all lesions, peripheral zone lesions and transition zone lesions at ultrahigh b-value DWI (kappa values were 0.738, 0.709 and 0.768 respectively). Conclusion: The diagnostic performance of ultrahigh b-value DWI is superior to high b-value DWI and T(2)WI in both peripheral zone and transition zone cancers.
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Affiliation(s)
- L B Ji
- Medical Imaging Center, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
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