Diagnostic value of apparent diffusion coefficient from diffusion-weighted imaging of 3.0T MRI in pathological grading of stage T1b clear cell renal cell carcinoma

TONG Xin; CHEN Yu; CHEN Xiaokang; SHANG Jiawei

doi:10.3969/j.issn.1007-8096.2025.12.024

Abstract：Objective To explore the diagnostic value of apparent diffusion coefficient(ADC)from diffusion-weighted imaging(DWI)of 3.0T magnetic resonance imaging(MRI)in pathological grading of stage T1b clear cell renal cell carcinoma(CCRCC).Methods A total of 120 patients with stage T1b CCRCC admitted to our hospital between January 2020 and November 2024 were enrolled.All patients underwent pathological examination and 3.0T MRI examination.According to the results of pathological examination,patients were divided into the low-grade group(71 cases,ISUP grading:grades I-II)and the high-grade group(49 cases,ISUP grading:grades Ⅲ-Ⅳ).The basic data and imaging characteristics of patients with different pathological grades were compared.ADC values in the regions of interest(tumor ADC value,peritumoral ADC value,and rADC)and positive expression of Ki-67 were recorded.The correlation between tumor ADC value,rADC value and positive expression of Ki-67 was analyzed.The diagnostic value of 3.0T MRI ADC value and rADC value in pathological grading of stage T1b CCRCC was analyzed by receiver operating characteristic(ROC)curves.Results There was no significant difference in basic data among patients with different pathological grades(P＞0.05).The lesion diameter,boundary definition,significant enhancement,bleeding,calcification and cystic necrosis rate in the high-grade group were significantly higher than those in the low-grade group(P＜0.05).The tumor ADC value and rADC value in the high-grade group were significantly higher than those in the low-grade group(P＜0.05),but there was no significant difference in peritumoral ADC value between the two groups(P＞0.05).The tumor ADC value and rADC value were negatively correlated with positive expression of Ki-67(P＜0.05).Through ROC curve analysis,for the diagnosis of pathological grading of stage T1b CCRCC,the area under the curve(AUC)of ADC value and rADC value was 0.863 and 0.811,the sensitivity was 89.80%and 70.42%,and the specificity was 77.55%and 76.06%,respectively(P＜0.05).Conclusion 3.0T MRI examination can effectively distinguish pathological characteristics of stage T1b CCRCC with different pathological grades and analyze the degree of tumor malignancy.The ADC value has high diagnostic value in pathological grading,which can be applied as an auxiliary diagnostic method for clinical evaluation.