MR Imaging of papillary renal neoplasms: potential application for characterization of small renal masses

Roy, Catherine; Sauer, B.; Lindner, Véronique; Lang, Hervé; Saussine, C.; Jacqmin, Didier

doi:10.1007/s00330-006-0271-9

Cited by 89 publications

(51 citation statements)

References 40 publications

(36 reference statements)

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“…Retrospectively, low signal intensity on T 2 -weighted MR images relative to the normal renal parenchyma and not so prominent vascularity on early-phase MDCT, that is, hypovascularity compared to conventional clear cell RCC, is consistent with the imaging features of papRCC. [8][9][10] However, theseˆndings could also represent malignant lymphoma. [11][12][13] Nevertheless, apparent signal reduction on the in-phase compared to out-of-phase image of chemical shift MR images, representing the presence of intratumoral hemosiderin, is considered speciˆc for papRCC, 8 and has not been reported for malignant lymphoma.…”

Section: Discussionmentioning

confidence: 99%

Papillary Renal Cell Carcinoma with Extensive Paraaortic Nodal Metastasis Mimicking Malignant Lymphoma

Mitsufuji¹,

Fujimitsu²,

Ida³

et al. 2011

magn reson med sci

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A 52-year-old woman with abdominal distension underwent computed tomography (CT) that demonstrated extensive paraaortic lymphadenopathy and a right renal mass. Compared to the renal cortex, the lesions exhibited low signal intensity on T 1 -and T 2 -weighted images and high intensity on diŠusion-weighted magnetic resonance (MR) images. We suspected malignant lymphoma and performed excisional biopsy, which revealed metastatic papillary renal cell carcinoma. Retrospectively, signiˆcantly reduced signal on in-phase chemical shift MR images compared to out-of-phase images suggested the presence of intratumoral hemosiderin, a characteristicˆnding of this entity.

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Section: Discussionmentioning

confidence: 99%

Papillary Renal Cell Carcinoma with Extensive Paraaortic Nodal Metastasis Mimicking Malignant Lymphoma

Mitsufuji¹,

Fujimitsu²,

Ida³

et al. 2011

magn reson med sci

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“…Both papillary carcinomas and angiomyolipomas tend to be T2-hypointense compared with the adjacent renal parenchyma, while clear cell carcinomas are iso-to hyperintense (36)(37)(38). Furthermore certain features such as the presence of intralesional fat are characteristic of angiomyolipomas.…”

Section: Genitourinary Imaging: Renal Cortical Tumorsmentioning

confidence: 99%

Renal Cortical Tumors: Use of Multiphasic Contrast-enhanced MR Imaging to Differentiate Benign and Malignant Histologic Subtypes

Vargas

Chaim²,

Lefkowitz³

et al. 2012

Radiology

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Purpose:To investigate the use of quantitative multiphasic contrast material-enhanced magnetic resonance (MR) imaging in differentiating between common benign and malignant histologic subtypes of renal cortical tumors. Materials and Methods:The institutional review board waived informed consent and approved this retrospective HIPAA-compliant study of 138 patients who underwent preoperative contrastenhanced MR imaging during the period of January 2004-December 2008. At surgery, 152 renal tumors were identified (77 clear cell, 22 papillary, 18 chromophobe, and 10 unclassified carcinomas; 16 oncocytomas; nine angiomyolipomas). Three readers independently identified and measured the most-enhanced area in each tumor and placed corresponding regions of interest in similar positions on images from the precontrast, corticomedullary, nephrographic, and excretory phases. The percentage change in signal intensity (%SI change) between precontrast imaging and each postcontrast phase was calculated.Interreader agreement was evaluated by using the overall concordance correlation coefficient (OCC). A linear mixed-effects model was used to estimate and compare the trajectories of the means of log %SI change across all phases between the six histologic subtypes. results:Interreader agreement was substantial to almost perfect (OCC, 0.77-0.88). The %SI change differed significantly between clear cell carcinomas and papillary and chromophobe carcinomas in all phases of enhancement (P , .0001-.0120). In addition, %SI change was significantly higher in angiomyolipomas than in clear cell carcinomas, but only in the corticomedullary phase (P = .0231). Enhancement did not differ significantly between clear cell carcinoma and oncocytoma in any phase (P = .2081-.6000). conclusion:Quantitative multiphase contrast-enhanced MR imaging offers a widely available, reproducible method to characterize several histologic subtypes of renal cortical tumors, although it does not aid differentiation between clear cell carcinomas and oncocytomas.q RSNA, 20121 From the Departments of Radiology (H

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“…21,27,28 The latter characteristic has been correlated with cytoplasmic or interstitial histiocytic hemosiderin deposition 22 and provides an accurate distinction from clear cell RCC, which typically exhibits heterogeneously increased signal intensity on T2-weighted images. 21,27 The histologic characteristics of cystic papillary RCC may be evident on diffusion tensor MRI because of restriction of the motion of water molecules along the well developed fibrous capsule and the fibrovascular core in the papillary projections. 29 The overall sensitivity and specificity of MRI to predict the histologic subtype using a feature analysis is 92% and 83% for clear cell RCC, and 80% and 94% for papillary RCC, respectively.…”

Section: Mri Phenotypes In Rccmentioning

confidence: 99%

“…21 Papillary carcinomas have other distinct MRI features that correlate with their unique histopathologic characteristics. 27,28 These tend to be located in the surface of the kidney, they are small in size, and they have homogeneous and lower signal intensity compared with the cortex on T2-weighted images. 21,27,28 The latter characteristic has been correlated with cytoplasmic or interstitial histiocytic hemosiderin deposition 22 and provides an accurate distinction from clear cell RCC, which typically exhibits heterogeneously increased signal intensity on T2-weighted images.…”

Section: Mri Phenotypes In Rccmentioning

confidence: 99%

“…27,28 These tend to be located in the surface of the kidney, they are small in size, and they have homogeneous and lower signal intensity compared with the cortex on T2-weighted images. 21,27,28 The latter characteristic has been correlated with cytoplasmic or interstitial histiocytic hemosiderin deposition 22 and provides an accurate distinction from clear cell RCC, which typically exhibits heterogeneously increased signal intensity on T2-weighted images. 21,27 The histologic characteristics of cystic papillary RCC may be evident on diffusion tensor MRI because of restriction of the motion of water molecules along the well developed fibrous capsule and the fibrovascular core in the papillary projections.…”

Section: Mri Phenotypes In Rccmentioning

confidence: 99%

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Magnetic resonance imaging as a biomarker in renal cell carcinoma

Pedrosa

Alsop

Rofsky

2009

Cancer

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The ability to noninvasively discriminate the most common types of renal cell carcinoma (RCC) based on their magnetic resonance imaging (MRI) appearances or their magnetic resonance phenotypes is achievable. Intracellular lipids, a histologic characteristic of the clear cell RCC, can be identified on chemical shift MRI. Intratumoral hemosiderin deposition, as observed histologically with papillary RCC, correlates to the low signal intensity on T2-weighted images. In addition to morphologic imaging features, the different subtypes of RCC have distinct patterns of enhancement on dynamic contrast-enhanced MRI. Clear cell tumors demonstrate much greater enhancement than papillary and chromophobe RCCs during the corticomedullary and nephrographic phases. The MRI technique arterial spin labeling (ASL) uses magnetic fields to label the water protons in arterial blood and measures blood flow into tissue; quantitative images of blood flow can be generated without exogenous contrast media. Multiple measurements of tumor perfusion may be repeated before and after a physiologic or drug challenge (ie, antiangiogenic therapy). In RCC xenografts and in patients with metastatic RCC, ASL MRI assessments can be used to monitor blood flow changes in response to antiangiogenic therapies. High blood flow on ASL MRI in RCC xenografts correlates with viable tumor at histopathologic analysis, whereas zones of absent or diminished signal correspond to necrosis. ASL MRI has the potential to serve as a biomarker for patients with metastatic RCC by offering a noninvasive measure of tumor blood flow changes accompanying antiangiogenic therapy. Cancer 2009;115(10 suppl):2334-45.

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MR Imaging of papillary renal neoplasms: potential application for characterization of small renal masses

Cited by 89 publications

References 40 publications

Papillary Renal Cell Carcinoma with Extensive Paraaortic Nodal Metastasis Mimicking Malignant Lymphoma

Papillary Renal Cell Carcinoma with Extensive Paraaortic Nodal Metastasis Mimicking Malignant Lymphoma

Renal Cortical Tumors: Use of Multiphasic Contrast-enhanced MR Imaging to Differentiate Benign and Malignant Histologic Subtypes

Magnetic resonance imaging as a biomarker in renal cell carcinoma

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