Assessing venous thrombus in renal cell carcinoma: preliminary results for unenhanced 3D-SSFP MRI
Adams LC, Ralla B, Engel G, Diederichs G, Hamm B, Busch J, Fuller F, Makowski MR (2018)
Publication Type: Journal article
Publication year: 2018
Journal
Book Volume: 73
Pages Range: 757.e9-757.e19
Journal Issue: 8
DOI: 10.1016/j.crad.2018.04.003
Abstract
Aim: To test the potential of unenhanced cardiac- and respiratory-motion-corrected three-dimensional steady-state free precession (3D-SSFP) magnetic resonance imaging (MRI) for the assessment of inferior vena cava (IVC) thrombus in patients with clear-cell renal cell carcinoma (cRCC), compared to standard contrast-enhanced (CE)-MRI and CE-computed tomography (CT). Materials and methods: Eighteen patients with cRCC and IVC thrombus, who received CE-MRI and 3D-SSFP at 1.5 T between June 2015 and December 2017, were included. The diagnostic performance of 3D-SSFP in determining the level of thrombus extension, contrast-to-noise ratio (CNR), and image quality were compared with standard MRI/CT and validated against intraoperative and histopathology results. Results: There was 100% agreement between 3D-SSFP, 83.3% agreement between CE-MRI, and 71.4% agreement between CE-CT and surgical findings regarding the level of IVC thrombus. In addition, 3D-SSFP showed a slightly superior estimate of pathological IVC volume. 3D-SSFP reached a significantly higher CNR in the supra- and infrarenal IVC compared to the morphological sequence T2-weighted half-Fourier axial single-shot fast spin-echo (T2-HASTE) and all phases of CE-MRI. More specifically, 3D-SSFP showed a significantly higher CNR in the infrarenal IVC (mean CNR of 10.09±5.74 versus 4.21±2.33 in the delayed phase, p≤0.001) and in the suprarenal IVC (mean CNR of 9.22±4.11 versus 4.84±5.74 in the late arterial phase, p=0.015). CE-CT also was significantly inferior to 3D-SSFP (p≤0.01) and slightly inferior to CE-MRI (p>0.05). The thrombus delineation score for 3D-SSFP (4.38±0.67) was higher compared to CE-MRI (3.76±0.56, p=0.005). Conclusion: This preliminary study indicates that 3D-SSFP can achieve an accurate assessment of IVC thrombus in cRCC patients without the need for contrast medium administration, being superior to standard MRI and CT.
Involved external institutions
Germany (DE)How to cite
APA:
Adams, L.C., Ralla, B., Engel, G., Diederichs, G., Hamm, B., Busch, J.,... Makowski, M.R. (2018). Assessing venous thrombus in renal cell carcinoma: preliminary results for unenhanced 3D-SSFP MRI. Clinical Radiology, 73(8), 757.e9-757.e19. https://dx.doi.org/10.1016/j.crad.2018.04.003
MLA:
Adams, L. C., et al. "Assessing venous thrombus in renal cell carcinoma: preliminary results for unenhanced 3D-SSFP MRI." Clinical Radiology 73.8 (2018): 757.e9-757.e19.
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