Investigation of Clear Cell Renal Cell Carcinoma Grades using Diffusion Relaxation Correlation Spectroscopic Imaging with Optimized Analysis

Motivation: The evaluation of diffusion-relaxation correlation spectrum imaging (DR-CSI) without prior knowledge has not been investigated. Goal(s): To differentiate high-grade from low-grade clear cell renal cell carcinoma using DR-CSI spectra in an equal separating analysis. Approach: The DR-CSI spectrum was segmented into multiple equal subregions from 2*2 to 9*9 and was evaluated based on their accuracy and repeatability. Results: Interreader agreement decreased as divisions in the equipartition model increased (from 0.859 to 0.920). Accuracy increased from 2x2 to 9x9 model (0.68 for 2x2, 0.69 for 3x3 and 4x4, 0.70 for 5x5, 0.71 for 6x6, 0.78 for 7x7, and 0.75 for 8x8 and 9x9). Impact: This study validated an method for extracting information from DR-CSI spectra based on the differentiation of high-grade from low-grade ccRCC without prior knowledge. It provides a reference for processing DR-CSI spectra, helping this technology be applied to other clinical scenarios.