Renal Masses: Quantitative Assessment of Enhancement with Dynamic MR Imaging

Ho, Vincent B.; Allen, Scott F.; Hood, Maureen N.; Choyke, Peter L.

doi:10.1148/radiol.2243011048

Cited by 201 publications

(99 citation statements)

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“…Masses were considered enhancing if after contrast medium there was an increase in attenuation of ≥ 20 HU [21], or a 20% increase in signal intensity [22]. Enhancement was deemed equivocal if the increase in CT attenuation was 10-20 HU, and if the increase in signal intensity was 15-20%.…”

Section: Methodsmentioning

confidence: 99%

Mixed epithelial and stromal tumour of the kidney: imaging features

et al. 2010

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Study Type – Diagnosis (case series) Level of Evidence 4OBJECTIVETo describe the features on ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) of mixed epithelial and stromal tumours of the kidney.PATIENTS AND METHODSFive women with renal mixed epithelial and stromal tumours (mean age 55.6 years, range 49–59) who had preoperative imaging were retrospectively analysed. Three ultrasonograms, five contrast‐enhanced CT scans, and one contrast‐enhanced MRI examination were available for review. Specific imaging features analysed included lesion size, location, enhancement and cystic composition. The presence of calcification, septation, nodularity and a capsule were also evaluated.RESULTSAll mixed epithelial and stromal tumours appeared as well‐marginated, multi‐septate cystic masses with a nodular component. All lesions were classified as Bosniak category III (three) or IV (two). The presence of calcification (four) or a capsule (three) was variable. Two tumours invaginated into the renal pelvis with no invasion.CONCLUSIONMixed epithelial and stromal tumours of the kidney have a diverse radiographic appearance, indistinguishable from multilocular cystic nephroma and cystic renal cell carcinoma.

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Section: Methodsmentioning

confidence: 99%

Mixed epithelial and stromal tumour of the kidney: imaging features

et al. 2010

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“…MRI techniques with rapid acquisition times, such as the fast imaging technique and single-shot pulse sequences, are now widely available and very effective with suspended respiration (12). The speed of these se-quences allows dynamic contrast-enhanced (DCE) MRI with or without fat suppression (13).…”

Section: The Role Of Mri In Renal Imagingmentioning

confidence: 99%

Subtypes of renal cell carcinoma: MRI and pathological features

Gürel¹,

Narra²,

Elsayes³

et al. 2013

Diagn Interv Radiol

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Renal cell carcinoma (RCC) is the most common malignant tumor involving the kidney. Determining the subtypes of renal cell carcinoma is among the major goals of preoperative radiological work-up. Among all modalities, magnetic resonance imaging (MRI) has several advantages, such as inherent soft tissue contrast, detection of lipid and blood products, and excellent sensitivity to detect small amounts of intravenous contrast, which facilitate the discrimination of subtypes of RCC. In this article, we review MRI and pathological features used for determining the main histologic subtypes of RCC, including clear cell, papillary, collecting duct, chromophobe, multilocular cystic, and unclassified RCC. Renal cell carcinoma (RCC) is the most common malignant epithelial tumor of the kidney, accounting for 85%-90% of all solid renal tumors in adults and comprising 1%-3% of all malignant visceral neoplasms (1). Approximately 40% of patients with RCC eventually die from progression of this disease, making it the most lethal urologic malignancy (2). Today, most RCC instances are incidental masses identified on imaging studies performed for nonurological reasons.Percutaneous biopsy is a minimally invasive method, and its accuracy for identifying renal tumors ranges from 70% to 90% (3, 4). However, widespread use of percutaneous biopsy remains controversial due to the potential complications of biopsy, the possibility of sampling errors, the dependence on an adequate biopsy sample for analysis, and concerns about how the biopsy information might alter the treatment plan (5). Therefore, histopathological characterization of renal masses with magnetic resonance imaging (MRI) compared with percutaneous biopsy becomes more advantageous.Determining subtypes of RCC has significant prognostic and theraupeutic implications for patients who are poor surgical candidates, for patients who have a metastatic disease, for surgical planning in patients who are surgical candidates, and for immunotherapy and use of the tyrosine kinase inhibitors "sunitinib" and "sorafenib" for clear cell RCC and "temsirolimus" for papillary RCC (6-9).The need for a different approach to the management of RCC among classical surgical procedures has arisen. Nephron-preserving surgical methods, cryoablation, radiofrequency ablation, targeted molecular therapy or follow-up, and MRI are believed to surpass other modalities both in the diagnosis of RCC and determination of its subtypes (10,11).In this article, we review MRI findings and pathological features used for determining the main histologic subtypes of RCC, including clear cell carcinoma, papillary, collecting duct, chromophobe, multilocular cystic, and unclassified RCC. The role of MRI in renal imagingThere are three indispensable components of renal MRI: breathhold imaging, three-dimensional (3D) gradient echo pulse sequence, and fat detection techniques.Breathhold imaging is one of the essential techniques in renal mass MRI protocols. Suspended expiration eliminates respiratory motion artifacts an...

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] Despite these advancements, some cases still remain for which CT or MRI cannot be used for the histological characterization of a renal tumor. For example, the differentiation of RCC from AML and infiltrating UC of the kidney can be difficult in some cases.…”

Section: Introductionmentioning

confidence: 99%

Utility of Apparent Diffusion Coefficients in the Evaluation of Solid Renal Tumors at 3T

Sasamori

Saiki

Suyama

et al. 2014

MRMS

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Purpose: We assessed the usefulness of apparent diffusion coefficients (ADCs) for solid renal tumor imaging using diffusion-weighted magnetic resonance imaging (DWI) at 3T.Methods: This retrospective study assessed ADCs of 31 patients with renal tumors that were imaged using preoperative DWI. DWI was performed with the b values of 50, 500, and 1000 s/mm 2 , using a 3T magnetic resonance imaging (MRI) system (MAGNETOM Trio, 3T, Siemens Healthcare, Erlangen, Germany). The ADC map was calculated using the b values of 50 and 1000 s/mm 2 . ADCs of the different tumors were compared according to the Tukey-Kramer test.Results: The tumors were diagnosed as clear cell renal cell carcinoma (RCC; n = 20), papillary RCC (n = 1), infiltrating urothelial carcinoma (UC) of the kidney (n = 4), cystic RCC (n = 1), poorly differentiated carcinoma (n = 1), and angiomyolipoma (AML; n = 4). The mean ADC of clear cell RCC was significantly higher than that of infiltrating UC of the kidney (1.423 vs. 0.931 © 10 ¹3 mm 2 /s; P < 0.05), and the mean ADC of AML was significantly lower than that of clear cell RCC (0.674 vs. 1.423 © 10 ¹3 mm 2 /s; P < 0.01). Conclusion: ADCs used in DWI at 3T may be useful for differentiation of different types of solid renal tumors.

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Renal Masses: Quantitative Assessment of Enhancement with Dynamic MR Imaging

Abstract: The optimal percentage of enhancement threshold for distinguishing cysts from malignancies with the imaging technique prescribed was 15%, and the optimal timing for measurement was 2-4 minutes after administration of contrast material.

Cited by 201 publications

References 14 publications

Mixed epithelial and stromal tumour of the kidney: imaging features

Mixed epithelial and stromal tumour of the kidney: imaging features

Subtypes of renal cell carcinoma: MRI and pathological features

Utility of Apparent Diffusion Coefficients in the Evaluation of Solid Renal Tumors at 3T

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