RENAL-CANCER STAGING - COMPARISON OF CONTRAST-ENHANCED CT AND GADOLINIUM-ENHANCED FAT-SUPPRESSED SPIN-ECHO AND GRADIENT-ECHO MR-IMAGING

Fifty-three consecutive patients with 61 solid or complex non-fat-cont aining renal masses compatible with renal cancer were examined with co ntrast-enhanced computed tomography (CT) and magnetic resonance (MR) i maging with pre- and postcontrast FLASH (fast low-angle shot) and fat- suppressed spin-echo sequences. CT and MR imaging were performed withi n a 1-month interval. CT and MR images were prospectively interpreted. Tumor detection and staging were determined in all patients. CT and M R imaging enabled detection of 54 and 58 of 61 renal tumors, respectiv ely. CT and MR imaging showed 34 and 35 of 38 histologically proved re nal tumors, respectively, in 31 patients. Tumor size on CT and MR imag es demonstrated good correlation and correlated well with the size of pathologic specimens of 34 of 38 resected tumors detected with CT and MR imaging (r = .99). Of the 31 tumors in 31 patients who underwent su rgical resection, 24 were correctly staged with CT and 29 with MR imag ing. CT and MR imaging both enabled correct staging of four of five ad ditional tumors with biopsy proof of tumor stage. A moderate differenc e in staging was observed between CT and MR imaging (P = .05). CT show ed 13 and MR imaging 15 of 15 tumor thrombi. CT and MR imaging both sh owed 11 of 11 cases of adenopathy. The results suggest that MR imaging is moderately better than CT for the detection and staging of renal c ancer.