title: Arterial spin labeling MR imaging for characterisation of renal masses in patients with impaired renal function: initial experience.
abstract: OBJECTIVE
  To retrospectively evaluate the feasibility of arterial spin labeling (ASL) magnetic resonance imaging (MRI) for the assessment of vascularity of renal masses in patients with impaired renal function.
  
  
  METHODS
  Between May 2007 and November 2008, 11/67 consecutive patients referred for MRI evaluation of a renal mass underwent unenhanced ASL-MRI due to moderate-to-severe chronic or acute renal failure. Mean blood flow in vascularised and non-vascularised lesions and the relation between blood flow and final diagnosis of malignancy were correlated with a 2-sided homogeneous variance t-test and the Fisher Exact Test, respectively. A p value <0.05 was considered statistically significant.
  
  
  RESULTS
  Seventeen renal lesions were evaluated in 11 patients (8 male; mean age = 70 years) (range 57-86). The median eGFR was 24 mL/min/1.73 m(2) (range 7-39). The average blood flow of 11 renal masses interpreted as ASL-positive (134 +/- 85.7 mL/100 g/min) was higher than that of 6 renal masses interpreted as ASL-negative (20.5 +/- 8.1 mL/100 g/min)(p = 0.015). ASL-positivity correlated with malignancy (n = 3) or epithelial atypia (n = 1) at histopathology or progression at follow up (n = 7).
  
  
  CONCLUSIONS
  ASL detection of vascularity in renal masses in patients with impaired renal function is feasible and seems to indicate neoplasia although the technique requires further evaluation.
  
  
  CONCLUSIONS
  Arterial spin labeling may help to characterise renal masses in patients with renal failure Detection of blood flow on ASL in a renal mass supports the presence of a neoplasm Renal masses with high blood-flow levels on ASL seem to progress rapidly.
authors.affiliation: Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, USA. ipedrosa@bidmc.harvard.edu
authors.forename: Ivan
authors.initials: I
authors.lastname: Pedrosa
authors.forename: Khashayar
authors.initials: K
authors.lastname: Rafatzand
authors.forename: Philip
authors.initials: P
authors.lastname: Robson
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Wagner
authors.forename: Michael B
authors.initials: MB
authors.lastname: Atkins
authors.forename: Neil M
authors.initials: NM
authors.lastname: Rofsky
authors.forename: David C
authors.initials: DC
authors.lastname: Alsop
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005355:Fibrosis / Q000473:pathology*; D005919:Glomerular Filtration Rate; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007668:Kidney / Q000473:pathology*; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D012189:Retrospective Studies; D013113:Spin Labels
chemical_list: D013113:Spin Labels