Tumor Heterogeneity of Renal Tumors Assessed by Multiparametric MRI With Direct Radiological-histopathological Correlation: an Explorative Study

A prospective single-center pilot study was performed on patients with solid renal tumors ≥2cm undergoing nephrectomy. Each patient underwent advanced preoperative 3.0T-mpMRI (including T2-weighted, pre-/postcontrast T1-weighted sequences, CS imaging, IVIM-DWI, and mapping). Tumor regions were jointly defined by a pathologist and radiologist. Identical Regions of Interest (ROIs) were assessed across all sequences to derive quantitative mpMRI parameters. Histopathology provided quantified regional fractions: viable tumor, fibrosis, hemorrhage, and cystic/necrotic components. Associations between these parameters were evaluated using Spearman's rank correlation and univariable linear regression at the regional level.

Inclusion criteria

• Patients with confirmed or suspected renal tumor with an approx. size of ≥ 2 cm who are scheduled for clinical MRI examination and surgical resection of the tumor
• Informed consent as documented by signature (Informed Consent Form)
• Patients ≥18 years of age

Exclusion criteria

• Women who are pregnant or breast feeding
• Intention to become pregnant during the course of the study and lack of safe contraception
• Inability to follow the procedures of the study, e.g., due to language problems, psychological disorders, dementia, etc. of the participant
• Previous enrolment into the current study
• Enrolment of the investigator, his/her family members, employees and other dependent persons
• Patients with non-MRI compatible metallic or electronic implants, devices or metallic foreign bodies (cardiac pacemaker, shrapnel, cochlea implants, neurostimulator, or other non-MRI compatible implants).
• Patients with known hypersensitivity reactions to MRI contrast agents will undergo the examination without application of a contrast agent