Wang Xiaojing, Keupp Jochen, Dimitrov Ivan E, Madhuranthakam Ananth, Udayakumar Durga, Taherzadeh Mahsa, Albayrak Emin, Moe Orson W, Kapur Payal, Lenkinski Robert E, Pedrosa Ivan, Vinogradov Elena
Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Philips Innovative Technologies, Hamburg, Germany.
Magn Reson Med. 2025 Dec;94(6):2374-2387. doi: 10.1002/mrm.30641. Epub 2025 Jul 22.
This study investigates the application of CEST MRI in human kidneys, with the overarching goal of developing CEST MRI for renal mass characterization. Here, the focus is on the development of a protocol and the proof-of-principle evaluation of CEST for the characterization of clear cell renal cell carcinoma (ccRCC).
Ten healthy volunteers and five patients diagnosed with ccRCC underwent CEST MRI scans at 3 T. The sequence performance was characterized in healthy volunteers and tested using three saturation power levels, B = 0.7, 1.2, and 1.6 μT. We compared the magnetization transfer ratio asymmetry (MTR) values at 1.0, 2.0, and 3.5 ppm between the kidney cortex of healthy volunteers and the cortex/renal masses of renal cell carcinoma (RCC) patients. We also investigated the correlation of CEST with tumor characteristics, such as volume, necrosis percentage, and histopathological grade.
Significant differences in MTR values were observed between ccRCC tumor regions and healthy kidney cortex in all three compared frequency offset ranges (p < 0.05). At the same time, MTR values in the cortex of the contralateral kidney in RCC patients were not significantly different when compared with the values of healthy kidney cortex values (p > 0.7).
CEST MRI demonstrates considerable potential as a non-invasive imaging tool for the characterization of renal masses.
本研究调查了CEST MRI在人体肾脏中的应用，总体目标是开发用于肾肿块特征描述的CEST MRI。在此，重点是开发一种方案以及对CEST用于透明细胞肾细胞癌（ccRCC）特征描述的原理验证评估。
10名健康志愿者和5名被诊断为ccRCC的患者在3T下接受了CEST MRI扫描。在健康志愿者中对序列性能进行了表征，并使用三种饱和功率水平（B = 0.7、1.2和1.6 μT）进行了测试。我们比较了健康志愿者肾皮质与肾细胞癌（RCC）患者皮质/肾肿块在1.0、2.0和3.5 ppm处的磁化传递率不对称（MTR）值。我们还研究了CEST与肿瘤特征（如体积、坏死百分比和组织病理学分级）之间的相关性。
在所有三个比较的频率偏移范围内，ccRCC肿瘤区域与健康肾皮质之间的MTR值均存在显著差异（p < 0.05）。同时，RCC患者对侧肾脏皮质的MTR值与健康肾皮质值相比无显著差异（p > 0.7）。
CEST MRI作为一种用于肾肿块特征描述的非侵入性成像工具具有相当大的潜力。
