Role of diffusion-weighted MRI for prediction of regional lymph node positivity in radiologically organ-confined renal tumour: a prospective study
Abstract Background Lymph node metastasis is one of the major factors that decide the prognosis of renal cell carcinoma. Presently, lymphadenectomy is only accepted as the most precise and dependable staging method to detect lymph node invasion; still, its therapeutic value for renal cell carcinoma...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-08-01
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| Series: | African Journal of Urology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12301-022-00307-5 |
| _version_ | 1798004400064561152 |
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| author | Ashish Ghanghoria Sasanka Kumar Barua T. P. Rajeev Puskal Kumar Bagchi Debanga Sarma Mandeep Phukan Vivek Sharma |
| author_facet | Ashish Ghanghoria Sasanka Kumar Barua T. P. Rajeev Puskal Kumar Bagchi Debanga Sarma Mandeep Phukan Vivek Sharma |
| author_sort | Ashish Ghanghoria |
| collection | DOAJ |
| description | Abstract Background Lymph node metastasis is one of the major factors that decide the prognosis of renal cell carcinoma. Presently, lymphadenectomy is only accepted as the most precise and dependable staging method to detect lymph node invasion; still, its therapeutic value for renal cell carcinoma is controversial. Diffusion-weighted magnetic resonance imaging along with its apparent diffusion coefficient value has already shown great value as a non-invasive modality to detect early microstructural changes in various human tumours. The present study is done to know the role of DWMRI in determining regional lymph node positivity in radiologically organ-confined renal cell carcinoma. Methods In this prospective study, we measured the ADC value of renal mass and regional lymph node in patient of RCC. ADC value < 1.25 is taken as cut-off to determine lymph node involvement. A malignant lymph node was confirmed by histopathology postoperatively. After that, we analysed the data retrospectively and studied the association between cut-off ADC value and lymph node positivity. Results Total 44 patients of RCC were evaluated in the study. Out of 44 patients, lymph node was found to be malignant on histopathology in 25 (56.8%) patients, and of these, 23 patients had ADC value < 1.25. This association was statistically significant (p < 0.05). The findings of DW MRI were accurate in 72.7% of patients with sensitivity of 63.1%, specificity of 80% and positive predictive value of 70.5%. Conclusions Lymph node with ADC value < 1.25 × 10–3 mm2/s has higher probabilities of harbouring malignant cell, so ADC value of DWMRI can be used as a sensitive and specific parameter to differentiate malignant lymph node from benign lymph node. However, our futuristic observation needs to be validated by multi-institutional large sample cohort. |
| first_indexed | 2024-04-11T12:23:03Z |
| format | Article |
| id | doaj.art-e6a0346795274235a34dbbe831b64cf3 |
| institution | Directory Open Access Journal |
| issn | 1110-5704 1961-9987 |
| language | English |
| last_indexed | 2024-04-11T12:23:03Z |
| publishDate | 2022-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | African Journal of Urology |
| spelling | doaj.art-e6a0346795274235a34dbbe831b64cf32022-12-22T04:24:03ZengSpringerOpenAfrican Journal of Urology1110-57041961-99872022-08-012811910.1186/s12301-022-00307-5Role of diffusion-weighted MRI for prediction of regional lymph node positivity in radiologically organ-confined renal tumour: a prospective studyAshish Ghanghoria0Sasanka Kumar Barua1T. P. Rajeev2Puskal Kumar Bagchi3Debanga Sarma4Mandeep Phukan5Vivek Sharma6Department of Urology, Super Speciality Hospital, Shyam Shah Medical CollegeDepartment of Urology, Gauhati Medical College and HospitalDepartment of Urology, Gauhati Medical College and HospitalDepartment of Urology, Gauhati Medical College and HospitalDepartment of Urology, Gauhati Medical College and HospitalDepartment of Urology, Gauhati Medical College and HospitalDepartment of Urology, Super Speciality Hospital, Shyam Shah Medical CollegeAbstract Background Lymph node metastasis is one of the major factors that decide the prognosis of renal cell carcinoma. Presently, lymphadenectomy is only accepted as the most precise and dependable staging method to detect lymph node invasion; still, its therapeutic value for renal cell carcinoma is controversial. Diffusion-weighted magnetic resonance imaging along with its apparent diffusion coefficient value has already shown great value as a non-invasive modality to detect early microstructural changes in various human tumours. The present study is done to know the role of DWMRI in determining regional lymph node positivity in radiologically organ-confined renal cell carcinoma. Methods In this prospective study, we measured the ADC value of renal mass and regional lymph node in patient of RCC. ADC value < 1.25 is taken as cut-off to determine lymph node involvement. A malignant lymph node was confirmed by histopathology postoperatively. After that, we analysed the data retrospectively and studied the association between cut-off ADC value and lymph node positivity. Results Total 44 patients of RCC were evaluated in the study. Out of 44 patients, lymph node was found to be malignant on histopathology in 25 (56.8%) patients, and of these, 23 patients had ADC value < 1.25. This association was statistically significant (p < 0.05). The findings of DW MRI were accurate in 72.7% of patients with sensitivity of 63.1%, specificity of 80% and positive predictive value of 70.5%. Conclusions Lymph node with ADC value < 1.25 × 10–3 mm2/s has higher probabilities of harbouring malignant cell, so ADC value of DWMRI can be used as a sensitive and specific parameter to differentiate malignant lymph node from benign lymph node. However, our futuristic observation needs to be validated by multi-institutional large sample cohort.https://doi.org/10.1186/s12301-022-00307-5Renal cell carcinoma (RCC)Magnetic resonance imaging (MRI)Diffusion-weighted magnetic resonance imaging (DWMRI)Apparent diffusion coefficient (ADC) |
| spellingShingle | Ashish Ghanghoria Sasanka Kumar Barua T. P. Rajeev Puskal Kumar Bagchi Debanga Sarma Mandeep Phukan Vivek Sharma Role of diffusion-weighted MRI for prediction of regional lymph node positivity in radiologically organ-confined renal tumour: a prospective study African Journal of Urology Renal cell carcinoma (RCC) Magnetic resonance imaging (MRI) Diffusion-weighted magnetic resonance imaging (DWMRI) Apparent diffusion coefficient (ADC) |
| title | Role of diffusion-weighted MRI for prediction of regional lymph node positivity in radiologically organ-confined renal tumour: a prospective study |
| title_full | Role of diffusion-weighted MRI for prediction of regional lymph node positivity in radiologically organ-confined renal tumour: a prospective study |
| title_fullStr | Role of diffusion-weighted MRI for prediction of regional lymph node positivity in radiologically organ-confined renal tumour: a prospective study |
| title_full_unstemmed | Role of diffusion-weighted MRI for prediction of regional lymph node positivity in radiologically organ-confined renal tumour: a prospective study |
| title_short | Role of diffusion-weighted MRI for prediction of regional lymph node positivity in radiologically organ-confined renal tumour: a prospective study |
| title_sort | role of diffusion weighted mri for prediction of regional lymph node positivity in radiologically organ confined renal tumour a prospective study |
| topic | Renal cell carcinoma (RCC) Magnetic resonance imaging (MRI) Diffusion-weighted magnetic resonance imaging (DWMRI) Apparent diffusion coefficient (ADC) |
| url | https://doi.org/10.1186/s12301-022-00307-5 |
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