Incidentally detected renal tumors are overtreated surgically: up to 20% of them are benign, most frequently oncocytomas. We hypothesize that integrating biomechanical assessment with functional/morphological MRI can improve lesion characterization, precluding unnecessary surgery. Initial experience in 5 resected renal oncocytomas and 13 renal cell carcinomas (RCC) demonstrates that MR Elastography (MRE) at 30Hz with shear modulus parametric mapping is feasible and adds value within a multiparametric MRI assessment: oncocytoma displays higher median shear attenuation (α) and lower shear velocity (C) than RCC. MRE parameters appear to be stronger classifiers than quantitative DCE MRI parameters (Ktrans, kep), ADC and T2 signal intensity.
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