Ankur Doshi MD, Presenter: Nothing to Disclose

William C. Huang MD, Abstract Co-Author: Nothing to Disclose

Nicholas Donin, Abstract Co-Author: Nothing to Disclose

James S. Babb PhD, Abstract Co-Author: Nothing to Disclose

Hersh Chandarana MD, Abstract Co-Author: Research support, Siemens AG

To determine MRI features of renal cell carcinoma (RCC) that are associated with lower histological grade, stage and favorable outcomes following resection.

This IRB-approved, retrospective study included 241 RCCs in 230 patients who had a preoperative contrast enhanced MRI, pathology results from surgically excised tumor, and at least 3 months of follow-up. A Board certified radiologist (abdominal radiology fellow), blinded to the pathology and clinical outcome, assessed tumor features on MRI, including pre-contrast T1 signal relative to renal cortex and percent of solid enhancing components. The electronic medical record and/or follow-up imaging were reviewed to assess for development of local recurrence or metastases. Statistical analysis was performed using Fisher’s exact test.

RCC subtypes included clear cell (n=144), papillary (n=59), chromophobe (n=21) and unclassified/other (n=17). On a patient level, the following tumor features were observed: solid component ≤25% (n=28), solid component >25% (n=202), T1 hypointensity (n=93) and T1 intermediate/hyperintensity (n=137). Mean follow-up time was 34 months (range 3 – 98). Local recurrence /metastases were observed in 14 patients (11 clear cell, 3 unclassified/other). RCC with T1 hypointensity and ≤25% solid component (n=14) showed no recurrence or metastases on follow-up. This group had lower stage (p<0.05) and clear cell grade (p<0.05) compared to tumors that wereT1 intermediate/hyperintense and >25% solid component (n=123). In a 24-month follow-up period, T1 hypointense signal alone was associated with decreased recurrence/metastases (p=0.05).

RCCs which are T1 hypointense and also have ≤25% solid enhancing component on MRI are associated with lower stage and nuclear grade. No recurrence or metastases were observed in this group.

Assessment of T1 signal and solid component on MRI can provide important prognostic information related to RCC tumor grade, stage and clinical outcome.

Doshi, A, Huang, W, Donin, N, Babb, J, Chandarana, H, MRI Features of Renal Cell Carcinoma that Predict Favorable Outcomes.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002273.html