Focal Nodular Enhancement on 3D MRI of Cystic Renal Lesions Predicts Malignancy
Smith M, Adey G, Pedrosa I, DeWolf W, Sanda M, Rofsky N
Beth Israel Deaconess Medical Center
We examined the positive predictive value (PPV) for malignancy of focal nodular enhancement in renal cystic lesions on 3D MRI. A surgical database was reviewed for patients at our institution having pre-operative 3D renal MRI and radical or partial nephrectomy during 52 months. Of 286 nephrectomies, 159 (56%) patients had pre-operative MRI studies. Of these, 21/159 (13%) lesions displayed focal nodular enhancement within a cystic lesion, 14 (67%) of which measured 10mm. Twenty (95%) of 21 lesions were renal cell carcinoma. The demonstration of solid enhancing nodular components provides excellent PPV (95%) for diagnosing neoplastic cystic renal lesions.