Imaging of renal lesions: evaluation of fast MRI and helical CT

Abstract

The purpose of this study is to compare triphasic helical CT and fast MRI with respect to detection, characterization and staging of suspected renal masses. To achieve this triphasic helical CT (plain, corticonephrographic and tubulonephrographic phase) and MRI with fast T(1) weighted and T(2) weighted sequences were performed in 29 patients with a suspected renal lesion. Image quality, lesion characterization and lesion extent were assessed for both methods in all patients. The acquisition phase for CT and the image sequence for MRI offering the best image quality and best diagnostic information regarding renal parenchyma, renal vessels, detection of enlarged lymph nodes, and other abdominal organs were determined. Histologically confirmed renal cell carcinomas (n=18) were staged based on the Robson classification. Quantitative data were obtained from operator-defined regions of interest (ROIs) in all acquisition phases (CT) and all image sequences (MRI). For most criteria the rating of image quality for helical CT was generally higher as compared with fast MRI. CT and MRI detected all 24 histologically proven masses, while no false positive solid tumour was diagnosed with both imaging modalities. All three acquisition phases in CT and all applied image sequences in MRI were regarded as necessary in order to gain important diagnostic information. Altogether, 12 of 18 renal cell carcinomas (67%) were correctly staged by CT and MRI. Helical CT and fast MRI allow the correct detection and characterization of suspicious renal lesions. Both imaging modalities can be recommended for clinical routine application. Although the correct histological staging of renal cancer remains difficult for both imaging methods, both are excellent in providing the critical staging information needed before surgery. Helical CT offers a significantly shorter acquisition time to cover the entire abdomen.

Comparison of 1.0 M gadobutrol and 0.5 M gadopentate dimeglumine-enhanced MRI in 471 patients with known or suspected renal lesions: results of a multicenter, single-blind, interindividual, randomized clinical phase III trial

“…The chosen equivalence limit in this study was based on the response rate of the study drug. The diagnostic efficacy rate of 0.5 M gadopentate was set to 85-90%, based on the available literature [28,29]. Overall, acceptable accuracy rates of about 85% were obtained in both treatment groups in the presented study.…”

Venous spread of renal cell carcinoma: MDCT

“…The latest generation of CT device, multidetector CT (MDCT), enables the further improvement of precision in evaluation of tumor extension. MDCT uses high-speed acquisition and due to its technical characteristics enables high-quality images without artifacts and 3D postprocessing [18,19] (Fig. 1).…”

Evaluation and management of kidney lesions: comparison of 16-MDCT and magnetic resonance imaging

“…The lesions with a major fat component are clearly depicted when they are 1cm in diameter or larger. They have high signal on T1-weighted images and much lower signal on fat-suppressed images, which clearly distinguish the mass outline from the rest of the renal parenchyma [11]. After contrast agent administration the mass is slightly enhanced, thus differing from tumors with a major vascular component that exhibit stronger contrast agent uptake.…”