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Intravoxel incoherent motion and diffusion kurtosis imaging in the assessment of pathological grades of clear cell renal cell carcinoma
Qing Xu1, Weiqiang Dou2, and Jing Ye1
1Department of Radiology, Clinical Medical School of Yangzhou University, Northern Jiangsu People’s Hospital, Yangzhou, 457, China, 2GE Healthcare, MR Research China, Beijing, China
IVIM-related parameters (ADC, apparent diffusion coefficient; D, true diffusivity) and DKI-related parameters (MD, mean diffusivity; MK, mean kurtosis) were able to significantly distinguish between low- and high-grade clear cell renal cell carcinoma. 
A 65-year-old woman with pathologically confirmed epithelioid angiomyolipoma in the left kidney. The lesion showed low signal intensity (SI) on T2-weighted image (a). (b-g) Corresponding parametric maps(ADC, D, D*,f, MD, MK). Tumor values (white arrow) were 0.51×10−3 mm2/s, 1.04×10−3 mm2/s, 57.8×10−3 mm2/s, 0.24, 1.67, 0.77, respectively. (h) pathological analysis displayed changes indicating ccRCC (Fuhrman II) (hematoxylin and eosin, ×200).
A 66-year-old man with pathologically confirmed clear cell renal cell carcinoma in the right kidney. The lesion showed very low signal intensity (SI) on T2-weighted image (a). (b-g) Corresponding parametric maps (ADC, D, D*,f, MD, MK). Tumor values (white arrow) were 0.32×10−3 mm2/s, 0.92×10−3 mm2/s, 10.09×10−3 mm2/s, 0.43, 1.05, 1.01, respectively. (h) pathological analysis confirmed ccRCC (Fuhrman IV) (hematoxylin and eosin, ×200).