title: Whole-body MRI in follow-up of patients with renal cell carcinoma.
abstract: BACKGROUND
  Recent technological advances have made whole-body MRI feasible within a reasonable time-frame. The clinical utility of whole-body MRI in patients with renal cell carcinoma has not been evaluated yet.
  
  
  OBJECTIVE
  To compare the diagnostic accuracy of whole-body MRI and computed tomography (CT) in follow-up of patients with renal cell carcinoma.
  
  
  METHODS
  In 28 patients with primary renal cell carcinoma a multislice CT scan of the thorax, abdomen, and pelvis, and a whole-body MRI were carried out as part of the postoperative follow-up. A combination of subsequent imaging studies and histology served as standard of reference.
  
  
  RESULTS
  MRI demonstrated a significantly better diagnostic accuracy regarding musculoskeletal metastases compared with CT (97.7% vs 82%, P<0.001). In contrast, CT was superior in the detection of pulmonary metastases (88.5% vs 71.9%, P<0.001). Both methods had similar diagnostic performance regarding lymph node metastases (CT, accuracy 82.4%; MRI, accuracy 83.4%, P=0.25). The concordance of both modalities regarding N and M stage was excellent (Cohen's kappa 1.00). In two patients cerebral metastases were revealed by MRI, which led to a change in therapy.
  
  
  CONCLUSIONS
  At this stage, whole-body MRI cannot be considered an adequate replacement for CT in the follow-up of patients with renal cell carcinoma. Further significant improvement of lung MR protocols is necessary, as CT's sensitivity for pulmonary nodules is clearly superior. In contrast, the main advantage of whole-body MRI is its high diagnostic accuracy for musculoskeletal metastases.
authors.affiliation: Department of Radiology, Dresden University of Technology, Dresden, Germany. ivan.platzek@uniklinikum-dresden.de
authors.forename: Ivan
authors.initials: I
authors.lastname: Platzek
authors.forename: Stefan
authors.initials: S
authors.lastname: Zastrow
authors.forename: Pierre-Emanuel
authors.initials: PE
authors.lastname: Deppe
authors.forename: Marc-Oliver
authors.initials: MO
authors.lastname: Grimm
authors.forename: Manfred
authors.initials: M
authors.lastname: Wirth
authors.forename: Michael
authors.initials: M
authors.lastname: Laniado
authors.forename: Christian
authors.initials: C
authors.lastname: Stroszczynski
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007472:Iohexol / Q000031:analogs & derivatives; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide; D019786:Gadolinium DTPA