Although MRI of the abdomen with IV contrast is considered in all major guidelines as an adequate method for the staging of RCC, imaging the pelvis for RCC staging is considered optional in the guidelines [5,13]. There is no relevant literature with high-quality evidence regarding the use of MRI of the pelvis in the staging of RCC. Although it is likely that MRI pelvis may not offer additional information in most patients with early stage RCC, pelvic imaging can be helpful in patients with more advanced RCC, in whom metastatic spread is suspected [47,48]. In patients with contraindications to both iodinated CT and gadolinium-based MRI IV contrast, unenhanced MRI may be preferred over noncontrast CT. This is due to the fact that unenhanced MRI has a superior soft tissue resolution compared to unenhanced CT, thereby increasing its diagnostic utility. MRI Abdomen MRI of the abdomen without and with IV contrast is considered to be a reliable method for the staging of RCC. Various MRI sequences, including T2-weighted, chemical shift T1-weighted, contrast-enhanced T1-weighted, and diffusion-weighted images, are typically obtained for the staging of RCC. In patients with contraindications to both iodinated CT and gadolinium-based MRI IV contrast, unenhanced MRI may be preferred over noncontrast CT. This is due to the fact that unenhanced MRI has a superior soft tissue resolution compared to unenhanced CT, thereby increasing its diagnostic utility. MRI Head Most patients with metastases to the central nervous system are symptomatic. Thus, current guidelines from the EAU and NCCN do not support routine imaging of the brain to search for metastases in asymptomatic patients in the initial staging of RCC. Brain imaging should be performed only in cases with suggestive signs or symptoms [5,13]. In symptomatic patients with contraindication to IV contrast, MRI brain without contrast may be helpful. Staging of Renal Cell Carcinoma
Staging of Renal Cell Carcinoma. Although MRI of the abdomen with IV contrast is considered in all major guidelines as an adequate method for the staging of RCC, imaging the pelvis for RCC staging is considered optional in the guidelines [5,13]. There is no relevant literature with high-quality evidence regarding the use of MRI of the pelvis in the staging of RCC. Although it is likely that MRI pelvis may not offer additional information in most patients with early stage RCC, pelvic imaging can be helpful in patients with more advanced RCC, in whom metastatic spread is suspected [47,48]. In patients with contraindications to both iodinated CT and gadolinium-based MRI IV contrast, unenhanced MRI may be preferred over noncontrast CT. This is due to the fact that unenhanced MRI has a superior soft tissue resolution compared to unenhanced CT, thereby increasing its diagnostic utility. MRI Abdomen MRI of the abdomen without and with IV contrast is considered to be a reliable method for the staging of RCC. Various MRI sequences, including T2-weighted, chemical shift T1-weighted, contrast-enhanced T1-weighted, and diffusion-weighted images, are typically obtained for the staging of RCC. In patients with contraindications to both iodinated CT and gadolinium-based MRI IV contrast, unenhanced MRI may be preferred over noncontrast CT. This is due to the fact that unenhanced MRI has a superior soft tissue resolution compared to unenhanced CT, thereby increasing its diagnostic utility. MRI Head Most patients with metastases to the central nervous system are symptomatic. Thus, current guidelines from the EAU and NCCN do not support routine imaging of the brain to search for metastases in asymptomatic patients in the initial staging of RCC. Brain imaging should be performed only in cases with suggestive signs or symptoms [5,13]. In symptomatic patients with contraindication to IV contrast, MRI brain without contrast may be helpful. Staging of Renal Cell Carcinoma