title: Vascular staging of renal and adrenal malignancies with a noncontrast enhanced steady state free precession technique.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA. lee.christine@mayo.edu
authors: Christine U
authors: CU
authors: Lee
authors: James F
authors: JF
authors: Glockner