Skip to main content
Erschienen in: Current Urology Reports 1/2012

01.02.2012 | New Techniques: Imaging (A Atala, Section Editor)

Advanced Renal Mass Imaging: Diffusion and Perfusion MRI

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

Erschienen in: Current Urology Reports | Ausgabe 1/2012

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Kang SK, Kim D, Chandarana H. Contemporary imaging of the renal mass. Curr Urol Rep. 2011;12(1):11–7.PubMedCrossRef Kang SK, Kim D, Chandarana H. Contemporary imaging of the renal mass. Curr Urol Rep. 2011;12(1):11–7.PubMedCrossRef
2.
Zurück zum Zitat Ho V, Allen S, Hood M, Choyke P. Renal masses: quantitative assessment of enhancement with dynamic MR imaging. Radiology. 2002;224:695–700.PubMedCrossRef 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Narumi Y, Miyazaki T, Hatanaka Y, et al. MR imaging evaluation of renal carcinoma. Abdom Imaging. 1997;22:216–25.PubMedCrossRef Narumi Y, Miyazaki T, Hatanaka Y, et al. MR imaging evaluation of renal carcinoma. Abdom Imaging. 1997;22:216–25.PubMedCrossRef
5.
Zurück zum Zitat 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. 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Chandarana H, Taouli B. Diffusion and perfusion imaging of the liver. Eur J Radiol. 2010 Chandarana H, Taouli B. Diffusion and perfusion imaging of the liver. Eur J Radiol. 2010
12.
Zurück zum Zitat Thoeny HC, De Keyzer F. Diffusion-weighted MR imaging of native and transplanted kidneys. Radiology. 2011;259(1):25–38.PubMedCrossRef Thoeny HC, De Keyzer F. Diffusion-weighted MR imaging of native and transplanted kidneys. Radiology. 2011;259(1):25–38.PubMedCrossRef
13.
Zurück zum Zitat Taouli B, Koh DM. Diffusion-weighted MR imaging of the liver. Radiology. 2010;254(1):47–66.PubMedCrossRef Taouli B, Koh DM. Diffusion-weighted MR imaging of the liver. Radiology. 2010;254(1):47–66.PubMedCrossRef
14.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat •• 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 •• 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat • 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 • 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat •• 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 •• 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.
Zurück zum Zitat • 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 • 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.
Zurück zum Zitat Choi H. Response evaluation of gastrointestinal stromal tumors. Oncologist. 2008;13 Suppl 2:4–7.PubMedCrossRef Choi H. Response evaluation of gastrointestinal stromal tumors. Oncologist. 2008;13 Suppl 2:4–7.PubMedCrossRef
25.
Zurück zum Zitat 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 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.
Zurück zum Zitat Padhani AR, Koh DM. Diffusion MR imaging for monitoring of treatment response. MRI Clin N Am. 2011;19:181–209. Padhani AR, Koh DM. Diffusion MR imaging for monitoring of treatment response. MRI Clin N Am. 2011;19:181–209.
27.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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. 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat • 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 • 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat • 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 • 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat • 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 • 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
Metadaten
Titel
Advanced Renal Mass Imaging: Diffusion and Perfusion MRI
verfasst von
Anthony G. Gilet
Stella K. Kang
Danny Kim
Hersh Chandarana
Publikationsdatum
01.02.2012
Verlag
Current Science Inc.
Erschienen in
Current Urology Reports / Ausgabe 1/2012
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-011-0227-8

Weitere Artikel der Ausgabe 1/2012

Current Urology Reports 1/2012 Zur Ausgabe

New Techniques: Imaging (A Atala, Section editor

Dual-energy Computed Tomography Applications in Uroradiology

Kidney Diseases (G Ciancio, Section Editor)

Current Status of Robot-Assisted Partial Nephrectomy

Viel pflanzliche Nahrung, seltener Prostata-Ca.-Progression

12.05.2024 Prostatakarzinom Nachrichten

Ein hoher Anteil pflanzlicher Nahrung trägt möglicherweise dazu bei, das Progressionsrisiko von Männern mit Prostatakarzinomen zu senken. In einer US-Studie war das Risiko bei ausgeprägter pflanzlicher Ernährung in etwa halbiert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Hypertherme Chemotherapie bietet Chance auf Blasenerhalt

07.05.2024 Harnblasenkarzinom Nachrichten

Eine hypertherme intravesikale Chemotherapie mit Mitomycin kann für Patienten mit hochriskantem nicht muskelinvasivem Blasenkrebs eine Alternative zur radikalen Zystektomie darstellen. Kölner Urologen berichten über ihre Erfahrungen.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.