Comparison of Contrast-Enhanced Multiphase Renal Protocol CT Versus MRI for Diagnosis of Papillary Renal Cell Carcinoma

Dilauro, Marc; Quon, Matthew; McInnes, Matthew D. F.; Vakili, Maryam; Chung, Andrew D.; Flood, Trevor A.; Schieda, Nicola

doi:10.2214/ajr.15.14932

Cited by 55 publications

(37 citation statements)

References 38 publications

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“…MRI is also useful in patients who are allergic to iodinated contrast material, cases of equivocal tumor contrast enhancement at CT because of the tumor cell type (particularly papillary RCC [21]), patients with renal dysfunction, cases of lesions with hemorrhage, and patients with specific contraindications to CT, such as pregnancy. The Localized renal cancer is defined as a stage I or II tumor that remains confined within the kidney capsule.…”

Section: Imaging Overviewmentioning

confidence: 99%

2017 AUA Renal Mass and Localized Renal Cancer Guidelines: Imaging Implications

et al. 2018

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Renal cell carcinoma (RCC) is a common cancer that is increasing in incidence because of the increased prevalence of risk factors, including tobacco use, hypertension, and obesity, and the improved detection of these tumors due to increased use of imaging. Localized renal cancer now accounts for more than 60%-70% of new RCC cases. Renal masses suggestive of cancer include enhancing solid renal lesions and Bosniak III and IV complex cystic lesions. Most of these tumors are detected incidentally, and many are slow growing with little propensity to metastasize. Radiologists have a vital role in evaluation of these tumors and subsequent patient counseling. Options for managing RCC include radical nephrectomy (RN), partial nephrectomy (PN), thermal ablation, and active surveillance. However, historically, the use of these strategies has varied among practices. Improved understanding of the biologic features of these tumors and data indicating the heterogeneous clinical course of many clinically localized renal tumors led to the development of the American Urological Association (AUA) Localized Renal Cancer Panel Guidelines in 2009, and these guidelines were updated in 2017. The format of the updated guidelines has moved from management recommendations based on index patients to individualized decision making, taking into account patient age and comorbidities, tumor characteristics, and important renal function considerations. A distinct role for RN is defined for cases of tumors with increased oncologic potential in patients with a normal contralateral kidney. Beyond this, nephron-sparing options, particularly PN, should be a priority. The updated guidelines also recommend increased use of renal mass biopsy, thermal ablation, and active surveillance in appropriately selected patients. The 2017 AUA guidelines are reviewed, with emphasis on the implications for practicing radiologists.

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Section: Imaging Overviewmentioning

confidence: 99%

2017 AUA Renal Mass and Localized Renal Cancer Guidelines: Imaging Implications

et al. 2018

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“…(5) However, more recent evidence with multi-energy CT technology have shown comparable performance of both methods for differentiation of pRCC from hemorrhagic cysts. (53) MR is more accurate than conventional venography and CT in delineating vena caval tumor thrombus. (54)…”

Section: Introductionmentioning

confidence: 99%

Imaging of Solid Renal Masses

Kay

Pedrosa

2018

Urologic Clinics of North America

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Detection of solid renal masses has increased in the last decades, although it has not resulted in significant mortality reduction from renal cell carcinoma. Consequently, efforts for improved lesion characterization have been pursued and incorporated in management algorithms, in order to distinguish clinically significant tumors from favorable or benign conditions. Concurrently, imaging methods have built a broad base of evidence supporting their role as useful tools not only in lesion detection, but also characterization. In addition, newer modalities, such as contrast enhanced ultrasound, and advanced applications of magnetic resonance imaging, are being investigated. The purpose of this paper is to review the current role of different imaging methods in the characterization of solid renal masses. MeshRenal cell carcinoma; Lymphoma; Angyomiolipoma; Renal oncocytoma; Ultrasound; X-ray computed tomography; Magnetic resonance imaging; Image-guided biopsy 1) IntroductionThe incidence of renal cancer has increased from 7.1 to 10.8 cases per 100,000 patients between 1983 and 2002, with most primary tumors initially diagnosed as incidental small renal masses (i.e., measuring less than or equal to 4 cm) during imaging studies performed for other clinical reasons. 1 Paradoxically, this increased in diagnosis has not been associated with better clinical outcomes, with a reported increase in mortality from 1.5 to 6.5 deaths per 100,000 patients within the same time interval. 2 Furthermore, the majority of incidentally detected tumors will either grow slowly 3 or not show detectable growth over time 4,5 . Therefore, cost-effective imaging strategies are necessary to identify clinically significant renal masses, which could evolve into life-threatening disease, while avoiding the unnecessary morbidity and financial costs associated with overtreatment of benign or favorable malignant conditions. * Corresponding author: ivan.pedrosa@utsouthwestern.edu. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptThe first step in the workup of incidentally found renal masses is to differentiate benign cysts from solid masses. 6,7 Solid renal masses contain little or no fluid, and are composed predominantly of vascularized tissue (i.e., elements enhancing with the administration of exogenous contrast agents). 7 Despite its lower prevalence compared to cystic lesions, up to 90% of solid masses are reported malignant. [8][9][10] The risk of malignancy is influenced by size, occurring in approximately 50% for lesions smaller than 1 cm and more than 90% for masses greater than or equal to 7 cm. 8Solid malignant masses most frequently encountered in clinical practice are renal cell carcinoma (RCC), urothelial carcinoma, lymphoma, and metastasis, while the most frequently encountered benign solid renal masses are angiomyolipoma (AML), oncocytoma, and inflammatory pseudotumors/pseudolesions. This article provides a comprehensive comprehensive approach to the imaging findings of common malignant a...

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“…CT and MRI are very useful examination methods that have been widely used in the diagnosis and differential diagnosis of diseases in various systems. Both have gained increased acceptance for accurate diagnosis and differential diagnosis of renal tumors [34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

CT and MRI Characteristic Findings of Sporadic Renal Hemangioblastoma: Two Case Reports and Review of the Literature

Liu

et al. 2020

Preprint

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BackgroundHemangioblastoma in the kidney is rare. Although a few renal hemangioblastoma cases have been reported, the content of these articles mainly focused on clinical and pathological research, with minimal descriptions of radiologic findings. Moreover, there are no descriptions of magnetic resonance imaging with enhancement for this condition. We herein report two cases of renal hemangioblastoma with computed tomography and magnetic resonance imaging findings.Case presentationTwo patients presented to our institution due to dull pain of the left abdomen, and a mass in the left kidney was found by ultrasound examination in each case. They had no special family history. Physical examination revealed no obvious tenderness or percussion pain in the renal region and ureteral walking area, and there was no obvious mass. Routine blood and urine tests were normal, and serum tumor markers were negative. No obvious lesions were found on imaging of other body parts. Similar radiologic findings were observed in both cases and mimicked those of cavernous hemangiomas of the liver, including peripheral nodular enhancement in the corticomedullary phase, progressive centripetal enhancement in the nephrographic and delayed phases, and occasional complete “filling in” in the delayed phase. Given the suspicion for renal cell carcinoma, both patients underwent partial nephrectomy. The pathological results showed renal hemangioblastoma.ConclusionsRenal hemangioblastoma is a rare benign tumor that is easily misdiagnosed as clear cell carcinoma. Characteristic computed tomography and magnetic resonance imaging manifestations may improve preoperative diagnostic accuracy to avoid surgery or indicate nephron-sparing surgery.

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Comparison of Contrast-Enhanced Multiphase Renal Protocol CT Versus MRI for Diagnosis of Papillary Renal Cell Carcinoma

Cited by 55 publications

References 38 publications

2017 AUA Renal Mass and Localized Renal Cancer Guidelines: Imaging Implications

2017 AUA Renal Mass and Localized Renal Cancer Guidelines: Imaging Implications

Imaging of Solid Renal Masses

CT and MRI Characteristic Findings of Sporadic Renal Hemangioblastoma: Two Case Reports and Review of the Literature

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