Multiparametric Magnetic Resonance Imaging of Solid Renal Tumors: A Practical Algorithm

Although preoperative classification of solid renal tumors was performed by percutaneous biopsy until now, research teams have demonstrated the potential interest of imaging to characterize noninvasively different renal tumor subtypes, in particular, with multiparametric magnetic resonance (MR) imaging. By combining all the imaging MR features successively reported in the literature and following a practical algorithm based on a step-by-step reading of the MR images, readers are now able to identify several imaging profiles, which appeared specific of each renal tumor subtypes. Although a large, prospective validation remains required to validate these findings in a clinical setting, this new imaging paradigm may help to overcome the traditional limitations of imaging for the characterization of renal tumors because of their overlapped morphologic imaging features. These imaging inputs would be helpful to better identify renal masses requiring surgery, without further invasive exploration such as biopsies, from where other options (ie, percutaneous ablation or active surveillance) may be proposed.