Arterial spin labeling MR imaging for characterisation of renal masses in patients with impaired renal function: Initial experience

Ivan Pedrosa, Khashayar Rafatzand, Philip Robson, Andrew A. Wagner, Michael B. Atkins, Neil M. Rofsky, David C. Alsop

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Objectives: To retrospectively evaluate the feasibility of arterial spin labeling (ASL) magnetic resonance imaging (MRI) for the assessment of vascularity of renal masses in patients with impaired renal function. Methods: Between May 2007 and November 2008, 11/67 consecutive patients referred for MRI evaluation of a renal mass underwent unenhanced ASL-MRI due to moderate-to-severe chronic or acute renal failure. Mean blood flow in vascularised and non-vascularised lesions and the relation between blood flow and final diagnosis of malignancy were correlated with a 2-sided homogeneous variance t-test and the Fisher Exact Test, respectively. A p value <0.05 was considered statistically significant. Results: Seventeen renal lesions were evaluated in 11 patients (8 male; mean age = 70 years) (range 57-86). The median eGFR was 24 mL/min/1.73 m 2 (range 7-39). The average blood flow of 11 renal masses interpreted as ASL-positive (134 +/- 85.7 mL/100 g/min) was higher than that of 6 renal masses interpreted as ASL-negative (20.5 +/- 8.1 mL/100 g/min)(p = 0.015). ASL-positivity correlated with malignancy (n = 3) or epithelial atypia (n = 1) at histopathology or progression at follow up (n = 7). Conclusions: ASL detection of vascularity in renal masses in patients with impaired renal function is feasible and seems to indicate neoplasia although the technique requires further evaluation. Key Points: Arterial spin labeling may help to characterise renal masses in patients with renal failure Detection of blood flow on ASL in a renal mass supports the presence of a neoplasm Renal masses with high blood-flow levels on ASL seem to progress rapidly

Original languageEnglish (US)
Pages (from-to)484-492
Number of pages9
JournalEuropean Radiology
Volume22
Issue number2
DOIs
StatePublished - Feb 1 2012

Keywords

  • Kidney neoplasms
  • Magnetic resonance imaging
  • Nephrogenic systemic fibrosis
  • Perfusion
  • Renal insufficiency

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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