Renal Cell Carcinoma Case Study

Decent Essays
Introduction Half of the population born in 1960 in the UK are predicted to be diagnosed with some type of cancer during their lifetime and renal cell carcinoma (RCC) is the 9th most common cancer type in the UK1,2. Its incidence is among the five fastest growing in both men and women and incidence rates are projected to continue rising.3,4 Despite the prognosis of RCC being heavily dependent on the stage at diagnosis, the increasing use of cross-sectional imaging and number of lesions detected at an early stage has not translated into an equally substantial reduction in RCC related death 5-10. The visual determination of the dignity of a lesion, especially in small tumours, has proven to be challenging, resulting in 10-20% of partial…show more content…
For the hyperpolarization of 13-C labelled pyruvate, dynamic nuclear polarization is employed using SPINlab (GE Healthcare) 22. Diffusion kurtosis imaging (DKI) is able to quantify Brownian motion of water molecules in tissue. Contrary to the established diffusion-weighted imaging (DWI) it does not assume a Gaussian distribution and can thereby quantify both the apparent diffusion coefficient (Dapp) and the deviation of the distribution of free water movement from a standard distribution in form of the apparent kurtosis (Kapp). These two parameters have been shown to offer complementarz information. Sodium (23Na) MRI measurs tissue sodium content (TSC) which is tightly controlled to maintain a number of physiological processes. Alterations in energy metabolism and necrosis influence cell membrane integrity and can result in changed tissue sodium content. This has been observed in tumours of the brain, breast and prostate. In some patients, positron emission tomography scans with flurodeoxyglucose (FDG-PET) as radiotracer may be performed at up to two time points before surgery. FDG is known to have a high avidity for metabolically active tissues and is used extensively in tumour diagnostics. These results will be correlated with metabolic information revealed in hp-13C-pyruvate imaging. Additionally, a standard renal MRI including DCE to assess the tumour vasculature will be
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