Magnetic Resonance Imaging and the Use in Small Renal Masses

The incidence of small renal masses (SRM) has been increasing, and this is mainly attributed to the incidental finding of such masses on imaging performed in asymptomatic patients. Consequently, this calls for careful evaluation and management of these masses to determine their nature and need for treatment. This article reviews current literature regarding the evaluation and management of SRM. It focuses on the specific use of MRI in the diagnosis and management of SRM. A Medline review of the literature was performed from 1996 to the present time. Computed tomography (CT) imaging has been the investigation of choice for evaluating SRM. However, some remain difficult to determine their malignant or benign nature and remain indeterminate. In such cases, further imaging with magnetic resonance imaging (MRI) can be performed to evaluate the mass in more detail. It can also be used where CT is contraindicated and where active surveillance is the treatment of choice and radiation exposure is a concern. MRI is a useful tool in evaluating an indeterminate small renal mass. Accurate diagnosis and management of SRM require close collaboration between a urologist and radiologist to identify potentially malignant tumours to subsequently reduce mortality from renal cell cancer.