Purpose: To compare a noncontrast enhanced balanced steady state free precession (bSSFP) MRI technique with a conventional dynamic contrast-enhanced (DCE) three-dimensional (3D) spoiled gradient recalled echo (SPGR) imaging in the vascular staging of renal and adrenal malignancies.
Materials and methods: Sixty-three MRIs with both bSSFP and DCE acquisitions performed for initial staging of renal and adrenal malignancies were retrospectively evaluated for presence and extent of thrombus in the renal veins and inferior vena cava (IVC). Thrombus characterization was also evaluated. DCE imaging was used as the standard-of-reference. Histopathology was available in 46 of 63 cases as an additional external standard.
Results: There is very good agreement between bSSFP and DCE imaging for determining the presence or absence of thrombus in the renal veins (r = 0.95; P < 0.0001) and IVC (r = 0.91; P < 0.0001). BSSFP is less successful at distinguishing bland from tumor thrombus.
Conclusion: Noncontrast enhanced bSSFP is an acceptable alternative to DCE imaging for vascular staging of locally advanced renal/adrenal malignancies, with somewhat limited ability to distinguish bland from tumor thrombus.
Copyright © 2011 Wiley-Liss, Inc.