Clear Cell Renal Cell Carcinoma Growth Correlates with Baseline                    Diffusion-weighted MRI in Von Hippel–Lindau Disease

Farhadi, Faraz; Nikpanah, Moozhan; Paschall, Anna K.; Shafiei, Ahmad; Tadayoni, Ashkan; Ball, Mark W.; Linehan, W. Marston

doi:10.1148/radiol.2020191016

Cited by 12 publications

(3 citation statements)

References 25 publications

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“…Abdominal renal protocol CT scan is the most sensitive diagnostic modality. Considering the recurrent and multifocal nature of renal disease, surgical resection with partial nephrectomy or nephron-sparing surgery is recommended for tumors greater than 3 cm ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Von Hippel–Lindau Disease (VHL): Characteristic Lesions with Classic Imaging Findings

Bajaj

Gandhi

Nayar

et al. 2023

jkcvhl

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Von Hippel–Lindau disease (VHL) is a multisystem cancer syndrome caused by the inactivation of the VHL tumor suppressor gene and involves various organ systems including the central nervous system (CNS), endocrine system, and the kidneys. Tumors seen in patients with VHL disease can be benign or malignant and are usually multifocal, bilateral, and hypervascular in nature. As most lesions associated with VHL are asymptomatic initially, early diagnosis and the institution of an evidence-based surveillance protocol are of paramount importance. Screening, surveillance, and genetic counseling are key aspects in the management of patients diagnosed with VHL disease and often require a multidisciplinary approach and referral to specialized centers. This article will discuss the characteristic lesions seen with VHL disease, their diagnosis, screening protocols and management strategies, as well as an illustrative case to demonstrate the natural progression of the disease with classic imaging findings.

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Section: Discussionmentioning

confidence: 99%

Von Hippel–Lindau Disease (VHL): Characteristic Lesions with Classic Imaging Findings

Bajaj

Gandhi

Nayar

et al. 2023

jkcvhl

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“…A recent study by Farhadi et al in 2020 correlated the relationship between apparent diffusion coefficient (ADC) and the growth rates of RCC for predicting the volume doubling time (VDT); ADC bearing a negative relationship with growth rate and positive relationship with VDT, thus, establishing the use of DWI in identifying RCCs with higher growth rates. 40 Imaging also plays an important role in targeted intervention. Percutaneous focal ablation, like CT-guided radio frequency ablation (RFA) and cryoablation, is the preferred treatment for RCCs in VHL as it significantly improves the cancer-free survival, 41 especially for smaller (< 3 cm) and multiple tumors.…”

Section: Li-fraumeni Syndromementioning

confidence: 99%

Imaging Recommendations for Diagnosis, Staging, and Management of Hereditary Malignancies

Majithia

Mahajan

Vaish

et al. 2023

Indian J Med Paediatr Oncol

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Hereditary cancer syndromes, characterized by genetically distinct neoplasms developing in specific organs in more than one family members, predispose an individual to early onset of distinct site-specific tumors. Early age of onset, multiorgan involvement, multiple and bilateral tumors, advanced disease at presentation, and aggressive tumor histology are few characteristic features of hereditary cancer syndromes. A multidisciplinary approach to hereditary cancers has led to a paradigm shift in the field of preventive oncology and precision medicine. Imaging plays a pivotal role in the screening, testing, and follow-up of individuals and their first- and second-degree relatives with hereditary cancers. In fact, a radiologist is often the first to apprise the clinician about the possibility of an underlying hereditary cancer syndrome based on pathognomonic imaging findings. This article focuses on the imaging spectrum of few common hereditary cancer syndromes with specific mention of the imaging features of associated common and uncommon tumors in each syndrome. The screening and surveillance recommendations for each condition with specific management approaches, in contrast to sporadic cases, have also been described.

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“…Although these results were recently confirmed using either ADC [ 92 ] or kurtosis tensor MR imaging—a more advanced type of DWI analysis [ 94 ]—the moderate sensitivity and specificity reported by these works may be insufficient for DWI to be a reliable single test to differentiate RCC subtypes [ 93 ]. In a study of 46 patients with Von Hippel–Lindau (VHL) disease, ADC at baseline was negatively correlated with the volume doubling time of 100 clear cells RCCs [ 95 ]. As active surveillance and kidney sparing surgery are important components of the management of VHL patients, assessment of tumor growth by ADC may be an important development of DWI in the future [ 96 ].…”

Section: Diffusion-weighted Renal Imagingmentioning

confidence: 99%

Diffusion-Weighted MRI in the Genitourinary System

Perrot

Zoua

Glessgen

et al. 2022

JCM

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Diffusion weighted imaging (DWI) constitutes a major functional parameter performed in Magnetic Resonance Imaging (MRI). The DW sequence is performed by acquiring a set of native images described by their b-values, each b-value representing the strength of the diffusion MR gradients specific to that sequence. By fitting the data with models describing the motion of water in tissue, an apparent diffusion coefficient (ADC) map is built and allows the assessment of water mobility inside the tissue. The high cellularity of tumors restricts the water diffusion and decreases the value of ADC within tumors, which makes them appear hypointense on ADC maps. The role of this sequence now largely exceeds its first clinical apparitions in neuroimaging, whereby the method helped diagnose the early phases of cerebral ischemic stroke. The applications extend to whole-body imaging for both neoplastic and non-neoplastic diseases. This review emphasizes the integration of DWI in the genitourinary system imaging by outlining the sequence’s usage in female pelvis, prostate, bladder, penis, testis and kidney MRI. In gynecologic imaging, DWI is an essential sequence for the characterization of cervix tumors and endometrial carcinomas, as well as to differentiate between leiomyosarcoma and benign leiomyoma of the uterus. In ovarian epithelial neoplasms, DWI provides key information for the characterization of solid components in heterogeneous complex ovarian masses. In prostate imaging, DWI became an essential part of multi-parametric Magnetic Resonance Imaging (mpMRI) to detect prostate cancer. The Prostate Imaging–Reporting and Data System (PI-RADS) scoring the probability of significant prostate tumors has significantly contributed to this success. Its contribution has established mpMRI as a mandatory examination for the planning of prostate biopsies and radical prostatectomy. Following a similar approach, DWI was included in multiparametric protocols for the bladder and the testis. In renal imaging, DWI is not able to robustly differentiate between malignant and benign renal tumors but may be helpful to characterize tumor subtypes, including clear-cell and non-clear-cell renal carcinomas or low-fat angiomyolipomas. One of the most promising developments of renal DWI is the estimation of renal fibrosis in chronic kidney disease (CKD) patients. In conclusion, DWI constitutes a major advancement in genitourinary imaging with a central role in decision algorithms in the female pelvis and prostate cancer, now allowing promising applications in renal imaging or in the bladder and testicular mpMRI.

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Clear Cell Renal Cell Carcinoma Growth Correlates with Baseline Diffusion-weighted MRI in Von Hippel–Lindau Disease

Cited by 12 publications

References 25 publications

Von Hippel–Lindau Disease (VHL): Characteristic Lesions with Classic Imaging Findings

Von Hippel–Lindau Disease (VHL): Characteristic Lesions with Classic Imaging Findings

Imaging Recommendations for Diagnosis, Staging, and Management of Hereditary Malignancies

Diffusion-Weighted MRI in the Genitourinary System

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