How accurate is MRI in the diagnosis of renal cell carcinoma (RCC)?

Updated: Dec 13, 2018
  • Author: Deborah A Baumgarten, MD, MPH; Chief Editor: Eugene C Lin, MD  more...
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The degree of confidence in the diagnosis with MRI is similar to that of CT. That is, confidence is high for lesions showing enhancement and less for cystic lesions. Thus, MRI has no advantage compared with contrast-enhanced CT for the diagnosis of RCC, but MRI is superior to nonenhanced CT.

As with CT, false-positive findings of RCC can occur with other solid-enhancing masses (metastatic disease, lymphoma, oncocytoma, non–fat-containing AML), which are virtually indistinguishable from RCC when they are solitary and when the relevant history is absent.

As with CT, a false-negative diagnosis can occur if cystic masses are not carefully examined for septa or nodularity, if enhancement of a lesion is missed (as a result of lack of contrast enhancement at the time of scanning), or if the masses are too small for adequate characterization at the time of their discovery.

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