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• Clinical Article •
Efficacy study of diffusion spectrum imaging-based habitat imaging in differentiating heterogeneity between clear cell renal cell carcinoma and fat-poor angiomyolipoma
SHI Nian  ZHANG Lei  MEI Chao  SHI Bowen  ZHANG Ninggui  RUAN Ao  YE Jing 

Cite this article as: SHI N, ZHANG L, MEI C, et al. Efficacy study of diffusion spectrum imaging-based habitat imaging in differentiating heterogeneity between clear cell renal cell carcinoma and fat-poor angiomyolipoma[J]. Chin J Magn Reson Imaging, 2025, 16(9): 105-111. DOI:10.12015/issn.1674-8034.2025.09.016.


[Abstract] Objectives To investigate the diagnostic value of habitat imaging based on diffusion spectrum imaging (DSI) for differentiating clear cell renal cell carcinoma (ccRCC) at different grades and fat-poor angiomyolipoma (fpAML).Materials and Methods A prospective study was conducted on 59 patients, all of whom underwent multi-b-value diffusion-weighted imaging (DWI) examination (0 to 3000 s/mm2). The apparent diffusion coefficient (ADC), the fractional order calculus (FROC) model-related parameters, the diffusion coefficient (D), the tissue heterogeneity-related parameters (fractional order parameter β), and the microstructure quantity (μ) were measured. The mean diffusivity (MD) and mean kurtosis (MK) of the diffusion kurtosis imaging (DKI) model-related parameters, as well as the true diffusion coefficient (Dt), pseudo-diffusion coefficient (D*), and perfusion fraction (f) of the intravoxel incoherent motion (IVIM) model-related parameters were also measured. Based on these parameters, the paired data of each voxel within the renal tumor region of all subjects were input into the K-means algorithm, and the renal tumors were classified into four habitats. The diagnostic value of these parameters for different grades of ccRCC and fpAML was analyzed using the receiver operating characteristic (ROC) curve.Results Habitat 1, characterized by low heterogeneity, high perfusion and low diffusion, and habitat 4, characterized by high heterogeneity, high perfusion and high diffusion, show differences in fpAML and ccRCC of different grades. Habitat 1 and 4 were statistically significant in differentiating fpAML and different grades of ccRCC (P < 0.05). Among them, the area under the curve (AUC) of habitat 1, 4 and their combination for differentiating fpAML and low-grade ccRCC was 0.90 [95% confidence interval (CI): 0.77 to 0.97], 0.84 (95% CI: 0.70 to 0.94), and 0.89 (95% CI: 0.76 to 0.97), respectively. The AUC of habitat 1 and their combination for differentiating fpAML and high-grade ccRCC was 0.68 (95% CI: 0.49 to 0.84) and 0.72 (95% CI: 0.53 to 0.87), respectively. The AUC of habitat 1, 4 and their combination for differentiating high and low grades of ccRCC was 0.73 (95% CI: 0.57 to 0.85), 0.76 (95% CI: 0.61 to 0.88), and 0.76 (95% CI: 0.60 to 0.87), respectively.Conclusions The use of habitat imaging based on DSI shows the potential of non-invasive diagnosis of fpAML and different grades of ccRCC in clinical practice, and has high accuracy.
[Keywords] clear cell renal cell carcinoma；fat-poor angiomyolipoma；magnetic resonance imaging；diffusion-weighted imaging；habitat imaging；differential diagnosis

SHI Nian1, 2   ZHANG Lei3   MEI Chao2   SHI Bowen2   ZHANG Ninggui2   RUAN Ao2   YE Jing1, 2*  

1 The Yangzhou Clinical Medical College of Xuzhou Medical University, Yangzhou 225001, China

2 Department of Radiology, Northern Jiangsu People's Hospital, Yangzhou 225001, China

3 Department of Radiology, The Affiliated Huaian Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huaian 223002, China

Corresponding author: JING Y, E-mail: yejing197206@163.com

Conflicts of interest   None.

Received  2025-04-16
Accepted  2025-09-10
DOI: 10.12015/issn.1674-8034.2025.09.016
Cite this article as: SHI N, ZHANG L, MEI C, et al. Efficacy study of diffusion spectrum imaging-based habitat imaging in differentiating heterogeneity between clear cell renal cell carcinoma and fat-poor angiomyolipoma[J]. Chin J Magn Reson Imaging, 2025, 16(9): 105-111. DOI:10.12015/issn.1674-8034.2025.09.016.

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