Transitional cell carcinoma of the upper urinary tract: staging by MRI

This study evaluates the ability of MRI to stage transitional cell carcinoma of the upper urinary tract.

Nine patients who had transitional cell carcinoma of the upper urinary tract detected by other imaging modalities underwent MRI examination at 1.5 T. Imaging included pre- and postgadolinium-DTPA T1-weighted images (9 patients) pre- and postgadolinium chelate T1-weighted fat-suppressed spin echo (7 patients). Postcontrast images were acquired prior to the presence of gadolinium within the collecting system (< 2 min postcontrast), intermediate (2.5-8 min), and late (> 10 min) postcontrast. Images were prospectively interpreted and lesion staging was determined. Correlation with histopathology was obtained in all cases.

Transitional cell cancers were demonstrated in 9/9 patients, and tumors ranged in size from 2 to 8 cm (mean = 3.8 cm) in one dimension. Correct tumor staging was performed in 8/9 patients. The staging error in one case occurred because direct tumor extension into the renal parenchyma was not detected.

The results of this preliminary study show that MRI stages transitional cell cancers relatively well; however, MRI is not able to detect superficial invasion of renal parenchyma.