Renal cell carcinoma
Magnetic Resonance Imaging (MRI) scans provide an image of the soft tissues in the body using radio waves and strong magnets. MRI can be used instead of CT if the patient exhibits an allergy to the contrast media administered for the test. Sometimes prior to the MRI scan, an intravenous injection of a contrasting material called gadolinium is given to allow for a more detailed image. Patients on dialysis or those who have renal insufficiency should avoid this contrasting material as it may induce a rare, yet severe, side effect known as nephrogenic systemic fibrosis. A bone scan or brain imaging is not routinely performed unless signs or symptoms suggest potential metastatic involvement of these areas.
MRI scans should also be considered to evaluate tumour extension which has grown in major blood vessels, including the vena cava, in the abdomen. MRI can be used to observe the possible spread of cancer to the brain or spinal cord should the patient present symptoms that suggest this might be the case.
Interventional magnetic resonance imaging
The non-magnetic environment required by the scanner and the strong magnetic radiofrequency and quasi-static fields generated by the scanner hardware require the use of specialized instruments. For example, use of non-magnetic (e.g. Titanium) surgical instruments and MR compatible patient surveillance accessories in addition to the MRI scanner itself increase the cost of IMRI. Often required is the use of an "open bore" magnet, which permits the operating staff better access to patients during the operation. Such open bore magnets are often lower field magnets, typically in the 0.2 tesla range, which decreases their sensitivity and temporal efficiency but also decreases the radio frequency power potentially absorbed by the patient during a protracted operation. Higher field magnet systems are beginning to be deployed in intraoperative imaging suites, which can combine high-field MRI with a surgical suite and even CT in a series of interconnected rooms. Specialty high-field interventional MR devices, such as the IMRIS system, can actually bring a high-field magnet to the patient within the operating theatre, permitting the use of standard surgical tools while the magnet is in an adjoining space.