Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Current Urology Reports
Published in: Current Urology Reports 1/2012

01-02-2012 | New Techniques: Imaging (A Atala, Section Editor)

Advanced Renal Mass Imaging: Diffusion and Perfusion MRI

Authors: Anthony G. Gilet, Stella K. Kang, Danny Kim, Hersh Chandarana

Published in: Current Urology Reports | Issue 1/2012

Login to get access

Abstract

Computed tomography (CT) is considered the imaging modality of choice in evaluation of renal lesions. The advantages of magnetic resonance imaging (MRI) compared to CT include superior soft tissue contrast, avoidance of ionizing radiation and iodinated contrast media, and the possibility of performing functional and advanced imaging techniques such as diffusion-weighted (DWI) and perfusion–weighted imaging (PWI). Although the traditional role of MRI in the evaluation of renal mass is primarily that of a problem-solving tool, DWI and PWI are expanding the role of MRI in management of renal cell cancers. DWI and PWI have shown considerable promise not only in renal lesion detection and characterization as benign or malignant, but also in assessment of renal cell cancer subtype and nuclear grade. Furthermore, these techniques have the potential to assist with tailoring patient- and disease-specific management by providing surgical planning in patients with localized renal cell cancer and assessing treatment response in patients with advanced renal cell cancer undergoing targeted chemotherapy.
Literature
1.
Kang SK, Kim D, Chandarana H. Contemporary imaging of the renal mass. Curr Urol Rep. 2011;12(1):11–7.PubMedCrossRef
2.
Ho V, Allen S, Hood M, Choyke P. Renal masses: quantitative assessment of enhancement with dynamic MR imaging. Radiology. 2002;224:695–700.PubMedCrossRef
3.
Hecht EM, Israel GM, Krinsky GA, et al. Renal masses: quantitative analysis of enhancement with signal intensity measurements versus qualitative analysis of enhancement with image subtraction for diagnosing malignancy at MR imaging. Radiology. 2004;232:373–8.PubMedCrossRef
4.
Narumi Y, Miyazaki T, Hatanaka Y, et al. MR imaging evaluation of renal carcinoma. Abdom Imaging. 1997;22:216–25.PubMedCrossRef
5.
Huch Böni RA, Debatin JF, Krestin FP. Contrast-enhanced MR imaging of the kidneys and adrenal glands. Magn Reson Imaging Clin North Am. 1996;4:101–31.
6.
Kallman DA, King BF, Hattery RR, et al. Renal vein and inferior vena cava tumor thrombus in renal cell carcinoma: CT, US, MRI and venacavography. J Computer Assist Tomogr. 1992;16(2):240–7.CrossRef
7.
Choyke PL, Walther MM, Wagner JR, et al. Renal cancer: preoperative evaluation with dual phase three-dimensional MR angiography. Radiology. 1997;205(3):767–71.PubMed
8.
Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182(3):844–53.PubMedCrossRef
9.
Hayn MH, Schwaab T, Underwood W, Kim HL. RENAL nephrometry score predicts surgical outcomes of laparoscopic partial nephrectomy. BJU Int. 2011;108(6):876–81.PubMed
10.
Kutikov A, Smaldone MC, Egleston BL, et al. Anatomic features of enhancing renal masses predict malignant and high-grade pathology: a preoperative nomogram using the RENAL nephrometry score. Eur Urol. 2011;60:241–8.PubMedCrossRef
11.
Chandarana H, Taouli B. Diffusion and perfusion imaging of the liver. Eur J Radiol. 2010
12.
Thoeny HC, De Keyzer F. Diffusion-weighted MR imaging of native and transplanted kidneys. Radiology. 2011;259(1):25–38.PubMedCrossRef
13.
14.
Kim S, Naik M, Sigmund E, Taouli B. Diffusion-weighted MR imaging of the kidneys and the urinary tract. Magn Reson Imaging Clin N Am. 2008;16(4):585–96.PubMedCrossRef
15.
Squillaci E, Manenti G, Di Stefano F, et al. Diffusion-weighted MR imaging in the evaluation of renal tumours. J Exp Clin Cancer Res. 2004;23:39–45.PubMed
16.
Cova M, Squillaci E, Stacul F, et al. Diffusion-weighted MRI in the evaluation of renal lesions: preliminary results. Br J Radiol. 2004;77:851–7.PubMedCrossRef
17.
•• Taouli B, Thakur RK, Mannelli L, et al. Renal lesions: characterization with diffusion-weighted imaging versus contrast-enhanced MR imaging. Radiology. 2009;251:398–407. According to this article, DWI can be used to characterize renal lesions; ADC values are significantly lower in renal malignancies than in benign lesions.PubMedCrossRef
18.
Squillaci E, Manenti G, Cova M, et al. Correlation of diffusion-weighted MR imaging with cellularity of renal tumours. Anticancer Res. 2004;24(6):4175–9.PubMed
19.
Zhang J, Tehrani YM, Wang L, et al. Renal masses: characterization with diffusion-weighted MR imaging–a preliminary experience. Radiology. 2008;247:458–64.PubMedCrossRef
20.
• Kim S, Jain M, Harris AB, et al. T1 hyperintense renal lesions: characterization with diffusion-weighted MR imaging versus contrast-enhanced MR imaging. Radiology. 2009;251:796–807. DWI is helpful in differentiating benign from malignant T1 hyperintense lesions.PubMedCrossRef
21.
Sandrasegaran K, Sundaram CP, Ramaswamy R, et al. Usefulness of diffusion-weighted imaging in the evaluation of renal masses. Am J Roent. 2010;194:438–45.CrossRef
22.
•• Wang H, Cheng L, Zhang X, et al. Renal cell carcinoma: diffusion-weighted MR imaging for subtype differentiation at 3.0 T. Radiology. 2010;257:135–43. The authors state that DWI is helpful in differentiating papillary and clear-cell subtype of RCC with high accuracy.PubMedCrossRef
23.
• Rosenkrantz AB, Niver BE, Fitzgerald EF, et al. Utility of the apparent diffusion coefficient for distinguishing clear cell renal cell carcinoma of low and high nuclear grade. Am J Roent. 2010;195:344–51. According to the authors, high nuclear grade clear cell RCCs have lower ADC compared to clear cell RCC of low grade.CrossRef
24.
25.
Smith AD, Shah SN, Rini BI, Lieber ML, Remer EM. Morphology, Attenuation, Size, and Structure (MASS) criteria: assessing response and predicting clinical outcome in metastatic renal cell carcinoma on antiangiogenic targeted therapy. AJR Am J Roentgenol. 2010;194(6):1470–8.PubMedCrossRef
26.
Padhani AR, Koh DM. Diffusion MR imaging for monitoring of treatment response. MRI Clin N Am. 2011;19:181–209.
27.
Kamel IR, Reyes DK, Liapi E, Bluemke DA, Geschwind JF. Functional MR imaging assessment of tumor response after 90Y microsphere treatment in patients with unresectable hepatocellular carcinoma. J Vasc Interv Radiol. 2007;18:49–56.PubMedCrossRef
28.
Leary A, Pickering LM, Larkin JMG, et al. Quantitative diffusion-weighted (DW) MR imaging of microcapillary perfusion and tissue diffusivity as biomarkers of response of renal cell carcinoma (RCC) to treatment with sunitinib. Presented at the 2011 American Society of Clinical Oncology Annual Meeting. Chicago, Il. J Clin Oncol 2011; 29: supplement abstract TPS154.
29.
Koh DM, Collins DJ, Orton MR. Intravoxel incoherent motion in body diffusion-weighted MRI: reality and challenges. AJR Am J Roentgenol. 2011;196(6):1351–61.PubMedCrossRef
30.
Chandarana H, Lee VS, Hecht E, Taouli B, Sigmund EE. Comparison of biexponential and monoexponential model of diffusion weighted imaging in evaluation of renal lesions: preliminary experience. Invest Radiol. 2011;46(5):285–91.PubMed
31.
Le Bihan D, Breton E, Lallemand D, et al. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology. 1988;168:497–505.PubMed
32.
Le Bihan D, Breton E, Lallemand D, et al. MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology. 1986;161:401–7.PubMed
33.
Hagiwara M, Rusinek H, Lee VS, et al. Advanced liver fibrosis: diagnosis with 3D whole-liver perfusion MR imaging–initial experience. Radiology. 2008;246:926–34.PubMedCrossRef
34.
Bokacheva L, Rusinek H, Zhang JL, Lee VS. Assessment of renal function with dynamic contrast-enhanced MR imaging. Magn Reson Imaging Clin N Am. 2008;16(4):597–611.PubMedCrossRef
35.
Sourbron SP, Buckley DL. On the scope and interpretation of the Tofts models for DCE-MRI. Magn Reson Med. 2011;66(3):735–45.PubMedCrossRef
36.
• Sun MR, Ngo L, Genega EM, Atkins MB, et al. Renal cell carcinoma: dynamic contrast-enhanced MR imaging for differentiation of tumor subtypes—correlation with pathologic findings. Radiology. 2009;250:793–802. This article shows that different enhancement patterns on two–time point dynamic contrast-enhanced MRI allow for differentiation between clear cell, papillary, and chromophobe RCCs.PubMedCrossRef
37.
Scialpi M, Di Maggio A, Midiri M, Loperfido A, Angelelli G, Rotondo A. Small renal masses: assessment of lesion characterization and vascularity on dynamic contrast-enhanced MR imaging with fat suppression. AJR Am J Roentgenol. 2000;175(3):751–7.PubMed
38.
• Notohamiprodjo M, Sourbron S, Staehler M, et al. Measuring perfusion and permeability in renal cell carcinoma with dynamic contrast-enhanced MRI: a pilot study. J Magn Reson Imaging. 2010;31(2):490–501. The authors show that perfusion-weighted MRI can provide information regarding tumor blood flow and permeability.PubMedCrossRef
39.
Hillman GG, Singh-Gupta V, Al-Bashir AK, et al. Dynamic contrast-enhanced magnetic resonance imaging of sunitinib-induced vascular changes to schedule chemotherapy in renal cell carcinoma xenograft tumors. Transl Oncol. 2010;3(5):293–306.PubMed
40.
Galbraith SM, Maxwell RJ, Lodge MA, et al. Combretastatin A4 phosphate has tumor antivascular activity in rat and man as demonstrated by dynamic magnetic resonance imaging. J Clin Oncol. 2003;21:2831–42.PubMedCrossRef
41.
• Flaherty KT, Rosen MA, Heitjan DF, et al. Pilot study of DCE-MRI to predict progression-free survival with sorafenib therapy in renal cell carcinoma. Cancer Biol Ther. 2008;7(4):496–501. In this article, the authors state that perfusion-weighted MRI not only can detect changes in tumor vascularity in response to antiangiogenic drugs, but also may be able to identify patients who are most likely to respond.PubMedCrossRef
Metadata
Title
Advanced Renal Mass Imaging: Diffusion and Perfusion MRI
Authors
Anthony G. Gilet
Stella K. Kang
Danny Kim
Hersh Chandarana
Publication date
01-02-2012
Publisher
Current Science Inc.
Published in
Current Urology Reports / Issue 1/2012
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-011-0227-8

Other articles of this Issue 1/2012

Current Urology Reports 1/2012 Go to the issue

Kidney Diseases (G Ciancio, Section Editor)

Current Status of Robot-Assisted Partial Nephrectomy

Kidney Diseases (G Ciancio, Section Editor)

Stem Cells as a Therapeutic Approach to Chronic Kidney Diseases

Kidney Diseases (G Ciancio, Section Editor)

Role of Cytoreductive Nephrectomy in the Era of Targeted Therapy for Renal Cell Carcinoma

Kidney Diseases (G Ciancio, Section Editor)

Evaluation and Management of Small Renal Masses: Looking Beyond the Tumor Margin

New Techniques: Imaging (A Atala, Section editor

Dual-energy Computed Tomography Applications in Uroradiology

New Techniques: Imaging (A Atala, Section Editor)

Value of Multiparametric MRI in the Work-up of Prostate Cancer