Immuno-oncologic profiling of renal masses using multiparametric MRI: a pilot study.

Area of Science:

• Renal cell carcinoma research
• Medical imaging
• Oncology

Background:

• Preoperative characterization of renal mass malignancy and subtype is crucial for tailored management.
• Understanding the tumor immune microenvironment can inform treatment decisions.

Purpose of the Study:

• To evaluate multiparametric MRI (mpMRI) for sensitivity to immuno-oncologic markers.
• To assess mpMRI's ability to classify tumor malignancy, subtype, and grade.

Main Methods:

• Prospective study of 40 patients undergoing preoperative 1.5T mpMRI.
• Utilized advanced MRI techniques including diffusion-weighted imaging (IVIM, ADC), R2*, ASL, and DCE-MRI.
• Correlated MRI biomarkers with immunohistochemistry results for immune cell markers (CD3, CD4, CD8, CD68) and angiogenesis (CD31) in clear cell renal cell carcinoma (ccRCC).

Main Results:

• IVIM parameters (f, D*, fD*) correlated with T cells (CD4, CD3, CD8).
• R2* correlated with macrophages (CD68) and angiogenesis (CD31).
• mpMRI demonstrated high accuracy in predicting malignancy and distinguishing ccRCC from non-ccRCC.

Conclusions:

• mpMRI is sensitive to immuno-oncologic biomarkers, aiding in characterizing the tumor immune microenvironment.
• Preoperative mpMRI can improve the characterization of renal mass malignancy and subtype.
• This supports mpMRI as a valuable tool for informed and tailored treatment management in renal masses.