MR Imaging of Renal Masses: Correlation with Findings at Surgery and Pathologic Analysis

Pedrosa, Iván; Sun, Maryellen; Spencer, Matthew D.; Genega, Elizabeth M.; Olumi, Aria F.; DeWolf, William C.; Rofsky, Neil M.

doi:10.1148/rg.284065018

Cited by 247 publications

(178 citation statements)

References 53 publications

Supporting

Mentioning

168

Contrasting

Unclassified

Order By: Relevance

“…4a). Cystic changes can be observed within a solid tumor, and central necrosis might be absent, even in very large chromophobe carcinomas (50). Signal loss on out of phase images due to microscopic fat has been reported (51).…”

Section: Chromophobe Rccmentioning

confidence: 99%

Subtypes of renal cell carcinoma: MRI and pathological features

Gürel¹,

Narra²,

Elsayes³

et al. 2013

Diagn Interv Radiol

View full text Add to dashboard Cite

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...

show abstract

Section: Chromophobe Rccmentioning

confidence: 99%

Subtypes of renal cell carcinoma: MRI and pathological features

Gürel¹,

Narra²,

Elsayes³

et al. 2013

Diagn Interv Radiol

View full text Add to dashboard Cite

show abstract

“…The annual rate of RCC diagnosis is increasing as a result of incidental detection by crosssectional abdominal imaging of patients with suspected abdominal disorders. Increased detection rates carry a favourable prognosis; however, mortality from RCC has not decreased [2][3][4].Diffusion-weighted imaging (DWI) is frequently used in cranial MRI studies and has shown potential for the characterisation of lesions such as acute cerebral infarctions, intracranial tumours, various infectious diseases and metabolic disorders [5][6][7][8]. The role of DWI is limited outside the central nervous system, owing to its inherent extreme sensitivity to motion, such as that related to respiration, peristalsis and artefacts, thus resulting in a high signal to noise ratio.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

The role of the ADC value in the characterisation of renal carcinoma by diffusion-weighted MRI

Paudyal

Paudyal²,

Tsushima³

et al. 2010

BJR

View full text Add to dashboard Cite

ABSTRACT. The purpose of this study is to evaluate the role of diffusion-weighted imaging (DWI) in combination with T 1 and T 2 weighted MRI for the characterisation of renal carcinoma. The institutional review board approved the study protocols and waived informed consent from all of the patients. 47 patients (32 male and 15 female; age range, 21-85 years; median age, 65 years) who had suspected renal lesions on abdominal CT underwent MRI for further evaluation and characterisation of the lesions from April 2005 to August 2007 in our university hospital. A region of interest was drawn around the tumour area on apparent diffusion coefficient (ADC) maps. Final diagnosis was confirmed by histological examination of surgical specimens from all patients. The ADC value was significantly higher in renal cell carcinoma (RCC) ; p50.0004), whereas intensity on T 1 and T 2 weighted imaging did not reach statistical significance. In conclusion, DWI has clinical value in the characterisation of renal carcinomas and could be applied in clinical practice for their management. Renal cell carcinoma (RCC) is the most common primary malignant tumour of the kidney; it accounts for 2-3% of all adult cancers and is the sixth cause of death by tumour throughout the world. More than 80% of renal cancers that arise in the renal parenchyma are RCC, whereas the majority of renal pelvis cancers are transitional cell carcinomas (TCCs) [1][2][3]. The three most common subtypes of RCC are (i) clear cell carcinoma, one of the most common types, accounting for 70-80% of cases; (ii) papillary renal cell carcinoma, accounting for about 10-15% of cases; and (iii) chromophobe renal carcinoma, which is the least common, accounting for 5% of all RCCs. The annual rate of RCC diagnosis is increasing as a result of incidental detection by crosssectional abdominal imaging of patients with suspected abdominal disorders. Increased detection rates carry a favourable prognosis; however, mortality from RCC has not decreased [2][3][4].Diffusion-weighted imaging (DWI) is frequently used in cranial MRI studies and has shown potential for the characterisation of lesions such as acute cerebral infarctions, intracranial tumours, various infectious diseases and metabolic disorders [5][6][7][8]. The role of DWI is limited outside the central nervous system, owing to its inherent extreme sensitivity to motion, such as that related to respiration, peristalsis and artefacts, thus resulting in a high signal to noise ratio. With the development of advanced MR technology and the use of faster robust sequences, better quality has been obtained in abdominal imaging [9]. DWI with high b-values has been reported to have a high sensitivity for depicting malignant disease. Apparent diffusion coefficient (ADC) values of malignant hepatic, ovarian, breast, prostatic, colonic and uterine cervical tumours were lower than those of benign lesions or normal tissue [10][11][12][13][14][15][16][17][18].Previous studies have suggested that patients with chromophobe and papillary RCC ha...

show abstract

“…The most common subtype of RCC, clear cell RCC, is usually heterogeneously hypervascular in the arterial phase. (5) It may be diffi cult to discern ill-defi ned enhancing soft tissue from adjacent heterogeneously hyperdense haematoma (Fig. 5), especially if the tumour is small.…”

Section: Discussionmentioning

confidence: 99%

Clinics in diagnostic imaging (178)

Chung

Chawla

Peh

2017

smedj

View full text Add to dashboard Cite

A 64-year-old woman with end-stage renal failure secondary to diabetic nephropathy was referred to the emergency department from the dialysis unit following intradialytic hypotension and giddiness. On further questioning, she described a four-day history of dull, non-radiating left fl ank pain. There was no history of trauma or iatrogenic injury such as renal biopsy.On examination, the patient had a palpable left fl ank mass. Admission laboratory serum tests revealed profound anaemia:

show abstract

MR Imaging of Renal Masses: Correlation with Findings at Surgery and Pathologic Analysis

Cited by 247 publications

References 53 publications

Subtypes of renal cell carcinoma: MRI and pathological features

Subtypes of renal cell carcinoma: MRI and pathological features

The role of the ADC value in the characterisation of renal carcinoma by diffusion-weighted MRI

Clinics in diagnostic imaging (178)

Contact Info

Product

Resources

About