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Updated: May 3, 2026
In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
Published on: March 30, 2015
Characterizing solid renal neoplasms with MRI in adults
Brian C Allen1, Philippe Tirman, M Jennings Clingan
1Department of Radiology, Medical Center Boulevard, Wake Forest Baptist Medical Center, 3rd Floor MRI, Winston Salem, NC, USA, 27157-1088, bcallen2@wakehealth.edu.
Abstract:
Until recently, most solid renal neoplasms without macroscopic fat were presumed to represent renal cell carcinoma and were indiscriminately treated with nephrectomy. Expanding surgical options and ablative technologies, a growing acceptance of renal mass biopsy, the advent of targeted molecular agents, and advances in our understanding of tumor biology have challenged the wisdom of this approach and are ushering in a potential new era in which therapy is linked to histologic subtype and cytogenetics. This approach mandates evolution of our diagnostic algorithm beyond the distinction between solid and cystic and enhancing and nonenhancing. Computed tomography (CT) has traditionally been the imaging technique of choice for evaluating potential solid renal tumors, in large part due to its widespread availability, high spatial resolution, calcium discrimination, and multiphase, enhanced imaging capabilities. For the most part, however, CT is limited to characterization based upon the attenuation and enhancement characteristics of a lesion and necessitates exposure of patients to ionizing radiation. For these latter reasons, multiparametric magnetic resonance imaging (MRI) is being increasingly used to characterize solid renal masses. The purpose of this manuscript is to review our imaging approach to solid renal masses in adults utilizing MRI with an emphasis on a multiparametric approach augmented by clinical data.
Insights
A new era of kidney cancer treatment is emerging, linking therapy to tumor type. Multiparametric MRI is becoming crucial for accurately diagnosing solid renal masses, moving beyond traditional CT scans.
Area of Science:
- Urology
- Radiology
- Oncology
Background:
- Historically, solid renal neoplasms without fat were often presumed to be renal cell carcinoma and treated with nephrectomy.
- Advances in surgical options, ablative technologies, renal mass biopsy, targeted therapies, and tumor biology understanding necessitate a shift.
- Current diagnostic algorithms focus on simple distinctions (solid/cystic, enhancing/non-enhancing), which are insufficient for personalized treatment.
Purpose of the Study:
- To review the current imaging approach for solid renal masses in adults.
- To emphasize the role of multiparametric magnetic resonance imaging (MRI) in characterizing these lesions.
- To highlight how clinical data can augment MRI findings for improved diagnosis.
Main Methods:
- Review of imaging techniques for solid renal masses.
- Focus on multiparametric MRI protocols.
- Integration of clinical data with imaging findings.
Main Results:
- Computed tomography (CT) has limitations in characterizing solid renal masses beyond attenuation and enhancement.
- CT involves ionizing radiation exposure.
- Multiparametric MRI offers a more comprehensive characterization of solid renal masses.
Conclusions:
- The traditional approach to solid renal masses is evolving towards subtype- and cytogenetic-specific therapies.
- Multiparametric MRI is increasingly vital for accurate characterization of solid renal masses.
- An integrated approach combining multiparametric MRI and clinical data is essential for this new era of personalized renal tumor management.
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