title: Dynamic contrast-enhanced magnetic resonance imaging assessment of kidney function and renal masses: single slice versus whole organ/tumor.
abstract: OBJECTIVE
  The aim of this study was to compare single-slice and 3-dimensional (3D) analysis for magnetic resonance renography (plasma flow [FP], plasma volume [VP], and glomerular filtration rate [GFR]) and for dynamic contrast-enhanced magnetic resonance imaging (MRI) of renal tumors (FP, VP, permeability-surface area product), respectively.
  
  
  METHODS
  We prospectively included 22 patients (43 kidneys with 22 suspicious renal lesions) and performed preoperative and postoperative imaging before and after partial nephrectomy, respectively. Of the 22 renal lesions, 15 turned out to be renal cell carcinoma and were included in the tumor analysis, altogether leading to 86 renal and 15 tumor MRI scans, respectively. Dynamic contrast-enhanced MRI was performed with a time-resolved angiography with stochastic trajectories sequence (spatial resolution, 2.6 × 2.6 × 2.6 mm3; temporal resolution, 2.5 seconds) at 3 T (Magnetom Verio; Siemens Healthcare Sector) after injection of 0.05 mmol/kg body weight Gadobutrol (Bayer Healthcare Pharmaceuticals). Analysis was performed using regions of interest encompassing a single central slice and the whole kidney/tumor, respectively. A 2-compartment model yielding FP, VP, GFR, or tumor permeability-surface area product was used for kinetic modelling. Modelling was performed based on relative contrast enhancement to account for coil-related inhomogeneity. Significance in difference, agreement, and goodness of fit of the data to the curve was assessed with paired t tests, Bland-Altman plots, and χ2 test, respectively.
  
  
  RESULTS
  Bland-Altman analysis revealed a good agreement between both types of measurement for kidneys and tumors, respectively. Results between single-slice and whole-kidney regions of interest showed significant differences for Fp (single slice, 256.1 ± 104.1 mL/100 mL/min; whole kidney, 217.2 ± 92.5 mL/100 mL/min; P < 0.01). Regarding VP and GFR, no significant differences were observed. The χ2 test showed a significantly better goodness of fit of the data to the curve for whole kidneys (0.30% ± 0.18%) than for single slices (0.43% ± 0.26%) (P < 0.01). In contrast to renal assessment, tumor analysis showed no significant differences regarding functional parameters and χ test, respectively.
  
  
  CONCLUSIONS
  In dynamic contrast-enhanced MRI of the kidney, both 3D whole-organ/tumor and single-slice analyses provide roughly comparable values in functional analysis. However, 3D assessment is considerably more precise and should be preferred if available.
authors.affiliation: From the *Institute for Clinical Radiology, †Josef-Lissner Institute for Biomedical Imaging, Institute for Clinical Radiology, and ‡Department of Urology, University Hospitals Munich, Munich; and §Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany.
authors.forename: Katharina S
authors.initials: KS
authors.lastname: Winter
authors.forename: Andreas D
authors.initials: AD
authors.lastname: Helck
authors.forename: Michael
authors.initials: M
authors.lastname: Ingrisch
authors.forename: Michael
authors.initials: M
authors.lastname: Staehler
authors.forename: Christian
authors.initials: C
authors.lastname: Stief
authors.forename: Wieland H
authors.initials: WH
authors.lastname: Sommer
authors.forename: Margarita
authors.initials: M
authors.lastname: Braunagel
authors.forename: Philipp M
authors.initials: PM
authors.lastname: Kazmierczak
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
authors.forename: Mike
authors.initials: M
authors.lastname: Notohamiprodjo
mesh_terms: D002292:Carcinoma, Renal Cell / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000175:diagnosis; D007680:Kidney Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media