title: Low-dose gadobenate dimeglumine-enhanced MRI of the kidney for the differential diagnosis of localized renal lesions.
abstract: OBJECTIVE
  To evaluate low-dose gadobenate dimeglumine-enhanced MRI for the differential diagnosis of malignant renal tumors.
  
  
  METHODS
  Sixty-two consecutive patients with unclear diagnosis at MDCT/ultrasound underwent dynamic CE-MRI of the kidneys with 0.05 mmol/kg gadobenate dimeglumine. Retrospective image evaluation was performed by two blinded readers. Lesion diagnosis at CE-MRI was correlated with findings from histology following tumor resection or from imaging follow-up after at least 1 year. Assessments were performed of diagnostic quality and level of diagnostic information.
  
  
  RESULTS
  Thirty-nine (63 %) patients were correctly diagnosed with malignant lesions (36 with RCC, 2 with renal metastases, 1 with lymphoma) while 14 (22.6 %) patients were correctly diagnosed with benign (n = 12) or no (n = 2) lesions. Eight patients were considered false positive (5 with oncocytoma, 3 with atypical AML) and 1 patient false negative (atypical RCC). The sensitivity, specificity, accuracy, PPV, and NPV for the diagnosis of malignant renal lesions were 97.5 % (39/40), 63.6 % (14/22), 85.5 % (53/62), 83.0 % (39/47), and 93.3 % (14/15), respectively. Images were excellent in 60 and good in 2 patients. Minimal artifacts that did not compromise diagnosis were noted in 4/62 patients.
  
  
  CONCLUSIONS
  Low-dose gadobenate dimeglumine-enhanced MRI is effective for the differential diagnosis of malignant renal tumors.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Saarland University Medical Center, 66421, Homburg/Saar, Germany. dr.guenther.schneider@uks.eu.
authors.forename: Guenther
authors.initials: G
authors.lastname: Schneider
authors.affiliation: Department of Diagnostic and Interventional Radiology, Saarland University Medical Center, 66421, Homburg/Saar, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Probst
authors.affiliation: Global Medical and Regulatory Affairs, Bracco Imaging SpA, Milan, Italy. miles.kirchin@bracco.com.
authors.forename: Miles A
authors.initials: MA
authors.lastname: Kirchin
authors.affiliation: Department of Diagnostic and Interventional Radiology, Saarland University Medical Center, 66421, Homburg/Saar, Germany.
authors.forename: Jonas
authors.initials: J
authors.lastname: Stroeder
authors.affiliation: Department of Diagnostic and Interventional Radiology, Saarland University Medical Center, 66421, Homburg/Saar, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Fries
authors.affiliation: Department of Diagnostic and Interventional Radiology, Saarland University Medical Center, 66421, Homburg/Saar, Germany.
authors.forename: Arno
authors.initials: A
authors.lastname: Buecker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016477:Artifacts; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000473:pathology; D002648:Child; D003287:Contrast Media / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008223:Lymphoma / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine
keywords: Gadobenate dimeglumine; Kidney; Renal MRI; Renal cell carcinoma