Original Research

Monoexponential, biexponential, and stretched exponential diffusion-weighted imaging models: Quantitative biomarkers for differentiating renal clear cell carcinoma and minimal fat angiomyolipoma

Haojie Li MD

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Lili Liang MD,

Lili Liang MD

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Anqin Li MD,

Anqin Li MD

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Yao Hu MD,

Yao Hu MD

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Daoyu Hu MD, PhD,

Daoyu Hu MD, PhD

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Zhen Li MD, PhD,

Corresponding Author

Zhen Li MD, PhD

[email protected]

orcid.org/0000-0001-8037-4245

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Address reprint requests to: Z.L., Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, China 430030. E-mail: [email protected]Search for more papers by this author

Ihab R. Kamel MD, PhD,

Ihab R. Kamel MD, PhD

Russell H. Morgan Department of Radiology and Radiological Science, the Johns Hopkins Medical Institutions, Baltimore, Maryland, USA

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Haojie Li MD,

Haojie Li MD

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Lili Liang MD,

Lili Liang MD

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Anqin Li MD,

Anqin Li MD

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Yao Hu MD,

Yao Hu MD

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Daoyu Hu MD, PhD,

Daoyu Hu MD, PhD

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Zhen Li MD, PhD,

Corresponding Author

Zhen Li MD, PhD

[email protected]

orcid.org/0000-0001-8037-4245

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Ihab R. Kamel MD, PhD,

Ihab R. Kamel MD, PhD

Russell H. Morgan Department of Radiology and Radiological Science, the Johns Hopkins Medical Institutions, Baltimore, Maryland, USA

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First published: 10 November 2016

https://doi.org/10.1002/jmri.25524

Citations: 44

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Abstract

Purpose

To determine the utility of various diffusion parameters obtained from monoexponential, biexponential, and stretched exponential diffusion-weighted imaging (DWI) models in differentiating between minimal fat angiomyolipoma (MFAML) and clear cell renal cell carcinoma (ccRCC).

Materials and Methods

One hundred thirty-one patients with pathologically confirmed MFAML (n = 27) or ccRCC (n = 104) underwent multi-b value DWI (0∼1700 s/mm²) imaging at 3.0 Tesla MRI. An isotropic apparent diffusion coefficient (ADC) was calculated from diffusion-weighted images by using a monoexponential model. A pseudo-ADC (D_p), true ADC (D_t), and perfusion fraction (f_p) were calculated from diffusion-weighted images by using a biexponential model. A water molecular diffusion heterogeneity index (α) and distributed diffusion coefficient (DDC) were calculated from diffusion-weighted images by using a stretched exponential model. All parameters were compared between MFAML and ccRCC by using the Student's t test. Receiver operating characteristic and intraclass correlation coefficient analysis were used for statistical evaluations.

Results

ADC, D_t, and α values were significantly lower in the MFAML group than in the ccRCC group (P < 0.001). D_p, f_p, and DDC values were slightly higher in the MFAML group than in the ccRCC group; however, the difference was not significant (P = 0.136, 0.090, and 0.424, respectively). The AUC values for both α (0.953) and D_t (0.964) were significantly higher than those for ADC (0860), D_p (0.605), f_p (0.596), and DDC (0.477) in the differentiation of MFAML from ccRCC (P < 0.001).

Conclusion

Water molecular diffusion heterogeneity index (α) and D_t may provide additional information and could lead to improved differentiation with better sensitivity and specificity between MFAML and ccRCC compared with conventional diffusion parameters.

Level of Evidence: 3

Technical Efficacy: Stage 2

J. MAGN. RESON. IMAGING 2017;46:240–247

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Volume46, Issue1

July 2017

Pages 240-247

Monoexponential, biexponential, and stretched exponential diffusion-weighted imaging models: Quantitative biomarkers for differentiating renal clear cell carcinoma and minimal fat angiomyolipoma

Abstract

Purpose

Materials and Methods

Results

Conclusion

References

Citing Literature

References

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Monoexponential, biexponential, and stretched exponential diffusion-weighted imaging models: Quantitative biomarkers for differentiating renal clear cell carcinoma and minimal fat angiomyolipoma

Abstract

Purpose

Materials and Methods

Results

Conclusion

References

Citing Literature

References

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