Relationship Between Apparent Diffusion Coefficient and Histologic Grading in Renal Cell Carcinoma

Abstract

Objective: Renal cell carcinoma (RCC) is the most common malignant lesion of the kidney. The Fuhrman nuclear grading system is the most widely used system for RCC as an independent predictor of prognosis. In terms of survival, it divided patients into a group with a good prognosis (Grade 1), a group with a poor prognosis (Grade 4) and a group with a prognosis between these two groups (Grades 2 and 3). MRI is the only method currently used to assess the molecular diffusion process in vivo. The aim of this study was to evaluate the relationship between apparent diffusion coefficient (ADC) values and Fuhrman nuclear grading and to investigate whether ADC values can contribute to preoperative prognosis. Materials and Methods: In this study, we evaluated 30 patients diagnosed with RCC in the Department of Pathology of our hospital who had diffusion weighted magnetic resonance images (DW-MRI) obtained with preoperative b 1000 gradient values. Measurements were made on ADC maps. Results: Nine of the cases were classified as Grade 1, 11 as Grade 2 and 10 as Grade 3. Mean ADC values according to nuclear grade were 1.68±0.64x10-3 sec/mm2, 1.16±0.20x10-3 sec/mm2, 1.35±0.45x10-3 sec/mm2 for Grade 1-3 respectively. When mean ADC values were compared according to nuclear grades, a statistically significant difference was observed between grades 1 and 2 (p<0.05). No significant difference was observed between the other groups (p>0.05). Conclusion: In this study, it was concluded that ADC values may be partially useful in the grading of RCC cases and may contribute to preoperative prognostic evaluation