E2205. Urine Luck: Multimodality Tips to Diagnosing Renal Masses
Santa Clara Valley Medical Center; Stanford University Medicine
University of California, Los Angeles
Stanford University Medicine
Benign and malignant renal masses may often have overlapping imaging features, which may complicate accurate diagnosis and management. Along with attenuation and enhancement characteristics on CT, intensity and enhancement characteristics on MR and acoustic characteristics on US, the advent of technology such as dual-energy CT and contrast-enhanced ultrasound are enabling the more accurate diagnosis of renal masses – especially in circumstances where a biopsy is difficult or not clinically appropriate.
Educational Goals / Teaching Points
- To review the differential diagnosis of renal masses.
- To understand the unique and overlapping imaging characteristics of renal masses on CT, MR and US.
- To learn the role of dual energy CT and contrast enhanced ultrasound in the diagnosis of renal masses.
- To learn the important tips of using multimodality imaging to aid in diagnosis of renal masses.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
- The exhibit will review the differential diagnosis of renal masses. This will include malignant masses (RCC and its subtypes, urothelial carcinoma, metastases and lymphoma), benign masses (oncocytoma, angiomyolipoma, metanephric adenoma and multicystic nephroma) and masslike lesions (such as renal abscess and focal pyelonephritis).
- The exhibit will subsequently review the multimodality imaging characteristics of renal masses, such as distinguishing water, enhancing tissue, hemorrhage and fat on MR, CT and US. The role of multiphasic MR and CT, as well as the utility of supplemental dual energy CT and contrast enhanced ultrasound, will be discussed.
- Next, problem-solving tips in aiding imaging diagnosis will be supplemented by a collection of sample cases, which will delineate methods to increase accuracy in diagnosis.
Benign and malignant renal masses may often have overlapping imaging features, which may complicate accurate diagnosis and management. Given the wide spectrum of benign and malignant etiologies, the role of the radiologist is essential in appropriately diagnosing and aiding management. By reviewing the differential considerations in the imaging appearance of renal masses using multimodality imaging, readers will have increased diagnostic acumen in diagnosis of renal masses.