Utility of the Apparent Diffusion Coefficient for Distinguishing Clear Cell Renal Cell Carcinoma of Low and High Nuclear Grade

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Abstract
OBJECTIVE. The purpose of our study was to assess the utility of the apparent diffusion coefficient (ADC) in distinguishing low-grade and high-grade clear cell renal cell carcinoma (ccRCC).MATERIALS AND METHODS. The cases of 57 patients with pathologically proven ccRCC who underwent preoperative MRI, including diffusion-weighted imaging, were retrospectively assessed. ADC values were obtained from ADC maps calculated using b-value combinations of 0 and 400 s/mm2 and of 0 and 800 s/mm2 (hereafter referred to as ADC-400 and ADC-800). Lesions were also evaluated for an array of conventional MRI features. A single expert uropathologist reviewed all slides to determine nuclear grade. The utility of ADC for detecting high-grade ccRCC, alone and in combination with conventional MRI features, was assessed using receiver operating characteristic (ROC) analysis and binary logistic regression.RESULTS. ADC-400 and ADC-800 were significantly lower among high-grade than among low-grade ccRCC (2.24 ± 0.50 mm2/s vs 1.59 ...

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