ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2022
vol. 87
 
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Urogenital radiology
abstract:
Original paper

Local recurrence of renal cell carcinoma after partial nephrectomy: applicability of the apparent diffusion coefficient of MRI as an imaging marker – a multicentre study

Yulian Mytsyk
1
,
Andriy Borzhiyevskyy
1
,
Ihor Dutka
2
,
Alexander Shulyak
3
,
Paweł Kowal
4
,
Dmytro Vorobets
1
,
Michał Skrzypczyk
5
,
Oleksandr Borzhiyevs’kyy
1
,
Andrzej Górecki
6
,
Viktoria Matskevych
7

1.
Department of Urology, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
2.
Medical Centre “Euroclinic”, Lviv, Ukraine
3.
Institute of Urology of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
4.
Department of Urology and Oncourology, Regional Specialist Hospital, Wroclaw, Poland
5.
Centre of Postgraduate Medical Education in Warsaw, Department of Urology, Warsaw, Poland
6.
Department of Radiology, Medical Care Centre, Jaroslaw, Poland
7.
Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
© Pol J Radiol 2022; 87: e325-e332
Online publish date: 2022/06/15
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Introduction
The goal of the study was an assessment of the diagnostic performance of diffusion-weighted images (DWI) and apparent diffusion coefficient (ADC) of magnetic resonance imaging (MRI) in distinguishing local recurrence (LR) of renal cell carcinoma (RCC) from benign conditions after partial nephrectomy.

Material and methods
Thirty-nine patients after partial nephrectomy for solid RCC were enrolled in the study. Patients were followed up using MRI, which included DWI sequence (b = 800 s/mm2). All patients with MRI features of LR were included in the main group (n = 14) and patients without such features – into the group of comparison (n = 25). Apparent diffusion coefficient (ADC) values of suspicious lesions were recorded. In all patients with signs of locally recurrent RCC, surgical treatment was performed followed by pathologic analysis.

Results
The mean ADC values of recurrent RCC demonstrated significantly higher numbers compared to benign fibrous tissues and were 1.64 ± 0.15 × 10-3 mm2/s vs. 1.02 ± 0.26 × 10-3 mm2/s (p < 0.001). The mean ADC values of RCCs’ LR and benign post-op changes in renal scar substantially differed from mean ADC values of healthy kidneys’ parenchyma; the latter was 2.58 ± 0.05 × 10-3 mm2/s (p < 0.001). In ROC analysis, the use of ADC with a threshold value of 1.28 × 10-3 mm2/s allowed us to differentiate local recurrence of RCC from benign postoperative changes with 100% sensitivity, 80% specificity, and accuracy: AUC = 0.980 (p < 0.001).

Conclusions
The apparent diffusion coefficient of DWI of MRI can be used as a potential imaging marker for the diagnosis of local recurrence of RCC.

keywords:

renal cell carcinoma, MRI, apparent diffusion coefficient, relapse, local recurrence, diffusion-weighted images




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