By Admin at 8 Mar 2018, 17:08 PM

Small kidney masses are often “accidentally” detected when a person receives a CAT scan for another purpose. Many such tumors are benign but once detected may be biopsied to determine whether they’re cancerous. Biopsies, however, are invasive and carry a risk of side effects, making them a less-than-ideal option, particularly if a less invasive strategy were available.

Researchers with the Kidney Cancer Program at UT Southwestern Harold C. Simmons Comprehensive Cancer Center in Dallas, Texas have uncovered one such option, developing a magnetic resonance imaging (MRI) technology that reveals kidney tumors’ composition without the need for a biopsy. The state-of-the-art multiparametric MRI (mpMRI) protocol uses multiple image types that allow researchers to evaluate the chemical composition of the tumor and ultimately detect what type of cancer it is.

Images include T2-weighted images, those taken immediately after intravenous dye reaches the kidney as well as those that reveal whether the tumor contains fat, a UT Southwestern Medical Center press release explained.[1] A standardized diagnostic algorithm based on the images is used to reveal whether the tumor is clear cell carcinoma (ccRCC), the most common and aggressive type of kidney cancer.

The study, published in The Journal of Urology,[2] involved the records of 110 patients with 121 kidney masses, who had previously received MRI and partial or full removal of the kidney. Seven radiologists with different levels of experience reviewed the records (but were unable to see the final pathology findings) and, using the algorithm, assigned each a clear cell likelihood score ranging from 1 (definitely not) to 5 (definitely). They were able to correctly detect clear cell carcinoma with 80 percent accuracy.

“A clear cell likelihood score used with magnetic resonance imaging can reasonably identify clear cell histology in small renal masses and may decrease the number of diagnostic renal mass biopsies,” the researchers wrote. Using the new technology, this suggests that doctors could correctly identify clear cell cancer in four out of five cases, without a biopsy.

Study author Jeffrey Cadeddu, professor of urology and radiology at UT Southwestern, explained, “Biopsies are not entirely free of pain and discomfort … If we can avoid the anxiety and the fear and the rare, but possible complication of a biopsy, I think we’re pushing medicine forward.”[3] It’s expected that more than 63,000 cases of kidney cancer will be diagnosed in 2018.[4]

Rates of this disease have been on the rise since the 1990s, but this may be due to increased use of CT scans and other imaging tests that have increased diagnosis. A non-invasive diagnostic tool like mpMRI is especially important since kidney cancer can often be cured when it is diagnosed and treated early, before it has spread beyond the kidney and the immediately surrounding tissue.

Sources:

1. UT Southwestern Medical Center January 2, 2018
2. The Journal of Urology October 2017, Volume 198, Issue 4, Pages 780-786
3. UT Southwestern Medical Center January 2, 2018
4. American Cancer Society, Kidney Cancer Statistics

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