CT and MRI of small renal masses

Wang, Zhen J.; Westphalen, Antonio C.; Zagoria, Ronald J.

doi:10.1259/bjr.20180131

Cited by 49 publications

(35 citation statements)

References 81 publications

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“…Surgery (partial or radical nephrectomy) remains the standard of care for young and healthy patients with incidentally found RCC. However, the substantial number of elderly patients with such tumors poses a clinical challenge, because rates of medical comorbidities and chances of renal impairment after surgery are generally higher among these patients [15]. This noninvasive quantitative mpMRI could prove clinically useful for treatment planning in elderly patients with comorbidities in whom biopsy or surgery is high risk, or to promote conservative treatment approaches such as active surveillance and focal ablation in eligible patients and is not part of the standard workup in most clinical centers [16].…”

Section: Discussionmentioning

confidence: 99%

Quantitative 3-tesla multiparametric MRI in differentiation between renal cell carcinoma subtypes

Elsorougy

Farg

Bayoumi

et al. 2021

Egypt J Radiol Nucl Med

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Background MRI provides several distinct quantitative parameters that may better differentiate renal cell carcinoma (RCC) subtypes. The purpose of the study is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC), chemical shift signal intensity index (SII), and contrast enhancement in differentiation between different subtypes of renal cell carcinoma. Results There were 63 RCC as regard surgical histopathological analysis: 43 clear cell (ccRCC), 12 papillary (pRCC), and 8 chromophobe (cbRCC). The mean ADC ratio for ccRCC (0.75 ± 0.13) was significantly higher than that of pRCC (0.46 ± 0.12, P < 0.001) and cbRCC (0.41 ± 0.15, P < 0.001). The mean ADC value for ccRCC (1.56 ± 0.27 × 10−3 mm2/s) was significantly higher than that of pRCC (0.96 ± 0.25 × 10−3 mm2/s, P < 0.001) and cbRCC (0.89 ± 0.29 × 10−3 mm2/s, P < 0.001). The mean SII of pRCC (1.49 ± 0.04) was significantly higher than that of ccRCC (0.93 ± 0.01, P < 0.001) and cbRCC (1.01 ± 0.16, P < 0.001). The ccRCC absolute corticomedullary enhancement (196.7 ± 81.6) was significantly greater than that of cbRCC (177.8 ± 77.7, P < 0.001) and pRCC (164.3 ± 84.6, P < 0.001). Conclusion Our study demonstrated that multiparametric MRI is able to afford some quantitative features such as ADC ratio, SII, and absolute corticomedullary enhancement which can be used to accurately distinguish different subtypes of renal cell carcinoma.

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Section: Discussionmentioning

confidence: 99%

Quantitative 3-tesla multiparametric MRI in differentiation between renal cell carcinoma subtypes

Elsorougy

Farg

Bayoumi

et al. 2021

Egypt J Radiol Nucl Med

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“…Evidentemente, las imágenes cumplen un rol preponderante en el manejo de las MRP. Actualmente, gracias a los avances tecnológicos, existen diversos protocolos para mejorar el diagnóstico de los tumores renales: imágenes pre y postadministración de contraste en tiempos predeterminados (90-120 segundos), evaluación de fases excretoras, presencia de grasa, cortes de 2-3 mm, entre otras 22 . Además, la resonancia magnética cada vez tiene mayor cabida en el diagnóstico diferencial de las MRP, especialmente en tumores con ausencia de tejido adiposo sugerentes de benignidad.…”

Section: Discussionunclassified

Masas renales pequeñas: predictores de malignidad en una serie de 10 años

2019

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Small renal masses. Analysis of 152 cases Background: Small renal masses (SRM) are defined as complex organ-confined solid or cystic lesions < 4 cm. Up to 20% of these can be benign. A conservative management with active surveillance can be done in some patients. However, it is difficult to identify patients with a higher risk of malignancy. Aim: To characterize the clinical, radiological and histopathological aspects of patients with SRM, analyzing predictive factors for tumor aggressiveness. Material and Methods: Retrospective analysis of a cohort of patients undergoing partial or total nephrectomy for renal tumors between 2006 and 2016. All tumors of 4 cm or less were included. Four histological groups were defined: benign, favorable, intermediate and unfavorable. Two categories of risk were also defined: low and high. Preoperative clinical and radiological variables of these patients were analyzed. Results: Data of 152 patients were analyzed. Six percent had a benign histology, and the majority was of intermediate risk (74%). According to histological type, clear cell carcinoma was the most common type (74%).

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“…For US guided ablation, three kinds of images are necessary including US, contrast-enhanced US, and either contrast-enhanced CT or magnetic resonance imaging (MRI). For the limited sensitivity of US modality for the detection of small RCCs [33], the use of micro-bubble contrast and MRI/ CT may increase the diagnostic accuracy of US and explicit the relationship between the lesion with the adjacent organs [34][35][36]. For CT guided ablation, contrast-enhanced CT is necessary for ablation planning and probe guidance, if the renal function of the patient permitted.…”

Section: Treatment Guidance Imagementioning

confidence: 99%

Percutaneous microwave ablation of renal cell carcinoma: practice guidelines of the ultrasound committee of Chinese medical association, interventional oncology committee of Chinese research hospital association

Cheng

et al. 2020

International Journal of Hyperthermia

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Imaging-guided percutaneous microwave ablation (MWA) with high thermal efficiency comprises rapid, successful management of small renal cell carcinomas (RCCs) in selected patients. Ultrasound Committee of Chinese Medical Association, Interventional Oncology Committee of Chinese Research Hospital Association developed evidence-based guidelines for MWA of RCCs after systematically reviewing the 1969-2019 literature. Systematic reviews, meta-analyses, randomized controlled trials, cohort, and case-control studies reporting MWA of RCCs were included and levels of evidence assessed. Altogether, 146 articles were identified, of which 35 reported percutaneous MWA for T1a RCCs and 5 articles for T1b RCCs. Guidelines were established based on indications, techniques, safety, and effectiveness of MWA for RCCs, with the goal of standardizing imaging-guided percutaneous MWA treatment of RCCs. KEY POINTS Microwave ablation is recommended for managing small renal cell carcinoma in selected patients. Imaging protocols are tailored based on the procedural plan, guidance, and evaluation. Patient's selection evaluation, updated technique information, clinical efficacy, and complications are recommended to standardize management. A joint task force (multidisciplinary team) summarized the key elements of the standardized report.

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CT and MRI of small renal masses

Cited by 49 publications

References 81 publications

Quantitative 3-tesla multiparametric MRI in differentiation between renal cell carcinoma subtypes

Quantitative 3-tesla multiparametric MRI in differentiation between renal cell carcinoma subtypes

Masas renales pequeñas: predictores de malignidad en una serie de 10 años

Percutaneous microwave ablation of renal cell carcinoma: practice guidelines of the ultrasound committee of Chinese medical association, interventional oncology committee of Chinese research hospital association

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