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Updated: Sep 8, 2025

In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
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Evaluation of renal masses with CEST MRI: Protocol optimization and preliminary results

Xiaojing Wang1, Jochen Keupp2, Ivan E Dimitrov3,4

  • 1Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Magnetic Resonance in Medicine
|July 22, 2025
PubMed
Abstract

Insights

Chemical Exchange Saturation Transfer (CEST) MRI shows promise for non-invasively characterizing renal masses. This technique can differentiate clear cell renal cell carcinoma (ccRCC) from healthy kidney tissue.

Area of Science:

  • Magnetic Resonance Imaging
  • Biomedical Engineering
  • Oncology

Background:

  • Renal mass characterization is crucial for diagnosis and treatment planning.
  • Current imaging techniques have limitations in differentiating benign from malignant renal masses.
  • Chemical Exchange Saturation Transfer (CEST) MRI is an emerging technique with potential for tissue characterization.

Purpose of the Study:

  • To develop and evaluate a CEST MRI protocol for human kidney imaging.
  • To assess the feasibility of using CEST MRI for characterizing clear cell renal cell carcinoma (ccRCC).
  • To investigate the diagnostic potential of CEST MRI in distinguishing ccRCC from healthy renal tissue.

Main Methods:

  • CEST MRI scans were performed at 3 Tesla on 10 healthy volunteers and 5 patients with ccRCC.
  • Magnetization Transfer Ratio Asymmetry (MTRasym) values were compared between ccRCC tumors and healthy kidney cortex across different frequency offsets.
  • Correlation between CEST parameters and tumor characteristics (volume, necrosis, grade) was analyzed.

Main Results:

  • Significant differences in MTRasym values were observed between ccRCC tumors and healthy kidney cortex (p < 0.05).
  • No significant differences in MTRasym values were found in the contralateral kidney cortex of RCC patients compared to healthy controls (p > 0.7).
  • CEST MRI shows potential for differentiating ccRCC from normal kidney parenchyma.

Conclusions:

  • CEST MRI is a promising non-invasive imaging tool for renal mass characterization.
  • The developed protocol enables differentiation of ccRCC from healthy kidney tissue.
  • Further research is warranted to explore the full clinical utility of CEST MRI in nephro-oncology.

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