Technical Note

Measuring perfusion and permeability in renal cell carcinoma with dynamic contrast-enhanced MRI: A pilot study

  1. Mike Notohamiprodjo MD1,†,*,
  2. Steven Sourbron PhD2,†,
  3. Michael Staehler MD3,
  4. Henrik J. Michaely MD4,
  5. Ulrike I. Attenberger MD4,
  6. Gerwin P. Schmidt MD1,
  7. Holger Boehm MD1,
  8. Annie Horng MD1,
  9. Christian Glaser MD1,
  10. Christian Stief MD3,
  11. Maximilian F. Reiser MD1,
  12. Karin A. Herrmann MD1

Article first published online: 23 JAN 2010

DOI: 10.1002/jmri.22028

Issue

Journal of Magnetic Resonance Imaging

Journal of Magnetic Resonance Imaging

Volume 31, Issue 2, pages 490–501, February 2010

Additional Information

How to Cite

Notohamiprodjo, M., Sourbron, S., Staehler, M., Michaely, H. J., Attenberger, U. I., Schmidt, G. P., Boehm, H., Horng, A., Glaser, C., Stief, C., Reiser, M. F. and Herrmann, K. A. (2010), Measuring perfusion and permeability in renal cell carcinoma with dynamic contrast-enhanced MRI: A pilot study. J. Magn. Reson. Imaging, 31: 490–501. doi: 10.1002/jmri.22028

Author Information

  1. 1

    Department of Clinical Radiology, University Hospitals Munich, Campus Grosshadern, Munich, Germany

  2. 2

    Josef Lissner Laboratory for Biomedical Imaging, Department of Clinical Radiology, University-Hospitals Munich, Campus Grosshadern, Munich, Germany

  3. 3

    Department of Urology, University Hospitals Munich, Campus Grosshadern, Munich, Germany

  4. 4

    Department of Clinical Radiology and Nuclear Medicine, University Medical Center, Mannheim, Germany

  1. †

    Drs. Notohamiprodjo and Sourbron contributed equally to this work.

*Department of Clinical Radiology, University Hospitals Munich, Campus Grosshadern, Marchioninistr. 15, D-81377 Munich, Germany

Publication History

  1. Issue published online: 23 JAN 2010
  2. Article first published online: 23 JAN 2010
  3. Manuscript Received: 20 NOV 2009
  4. Manuscript Accepted: 27 OCT 2009

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Keywords:

  • RCC;
  • DCE-MRI;
  • neoadjuvant antiangiogenic therapy;
  • perfusion;
  • two-compartment-model;
  • tumor

Abstract

Purpose:

To retrospectively assess an improved quantitative methodology with separate assessment of perfusion and permeability for characterization of primary renal cell carcinoma (RCC) and monitoring antiangiogenic treatment.

Materials and Methods:

Fifteen RCC patients before surgery, 6 RCC patients before and after neoadjuvant antiangiogenic therapy, and 15 patients without renal disease underwent dynamic contrast-enhanced (DCE)-MRI of the kidney with integrated retrospective respiratory triggering and an individual arterial input function. Tracer kinetic analysis was performed with a two-compartment-filtration-model for the kidney data and a two-compartment-exchange-model for the tumor data, providing four independent parameters: the perfusion-parameters plasma flow (FP) and plasma volume (VP), and the permeability-parameters extraction flow (FE) and extravascular-extracellular volume (VE).

Results:

In tumors FP and FE were significantly lower than in normal kidneys. Tracer kinetic analysis displayed hemodynamic alteration caused by vessel infiltration or necrosis. Papillary RCC could be differentiated from clear-cell variants by a distinct perfusion pattern. In antiangiogenically treated RCC VE was not significantly decreased, while the perfusion parameters VP and FP were significantly diminished.

Conclusion:

DCE-MRI with integrated motion compensation enables evaluation of primary RCC and detects distinct perfusion patterns. Quantification with a two-compartment-exchange-model produces a separate perfusion- and permeability characterization and may become a diagnostic tool to monitor antiangiogenic treatment. J. Magn. Reson. Imaging 2010; 31: 490–501. © 2010 Wiley-Liss, Inc.

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