What question did this study set out to answer?

The aim is to assess the sodium content of localized renal tumours using 23Na-MRI for better differentiation between benign and malignant types.

June 7, 2026Open Access

Estimating the Sodium Content: a Case Series of Benign and Malignant Renal Tumours using 23Na-MRI at 3 T

Key Points

The aim is to assess the sodium content of localized renal tumours using 23Na-MRI for better differentiation between benign and malignant types.
Prospectively recruited case series of ten patients with localized renal tumours.
Utilized 23Na-MRI at 3 T to measure sodium content alongside 1H-MRI for correlation with other imaging parameters.
Quantified parameters included total sodium concentration, relaxation rates, perfusion fraction, and diffusion coefficient.
Mean apparent total sodium concentration in clear cell RCC was 135 ± 59 mM and in papillary RCC was 81 mM.
Significantly higher sodium concentration in renal oncocytomas (162 ± 58 mM) compared to chromophobe RCCs (71 ± 2 mM, P < 0.05).
Inversely correlated sodium concentration with 1H-R2* (Spearman r = -0.39, P < 0.05).

Abstract

Accurate and non-invasive subtyping of localised renal tumours is an important unmet clinical challenge in uro-oncology and has significant implications for patient mortality and quality of life. Developing novel imaging methods to characterise and stratify indeterminate kidney tumours at an early stage has the potential to address this clinical challenge. Here we applied sodium MRI (23Na-MRI) to estimate kidney tumour sodium content in a prospectively recruited case series of ten patients (mean age ± S.D. 64 ± 8 years; 7:3 male:female ratio). The patients had localised renal tumours which included six renal oncocytomas (ROs), two chromophobe renal cell carcinomas (chRCCs), three clear cell RCCs (ccRCC), and one papillary RCC (pRCC). The patients underwent 23Na-MRI at 3 T (3D sodium cones and double-angle B1 mapping) and 1H-MRI which included R2* mapping and intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI). The following imaging parameters were quantified within the renal tumours and in the normal-appearing kidney parenchyma: apparent total sodium concentration (TSC); apparent 23Na and 1H relaxation rates (R2*); perfusion fraction (fp); and diffusion coefficient (Dt). 23Na-MRI findings were correlated with conventional 1H-MRI measures of perfusion, hypoxia, and cellularity. The mean apparent TSC in ccRCC and in pRCC were 135 ± 59 mM and 81 mM, respectively. The apparent TSC was significantly higher in ROs compared to chRCCs: 162¬ ± 58 mM vs. 71 ± 2 mM (P < 0.05). The apparent TSC inversely correlated with 1H-R2* (Spearman r = -0.39, P < 0.05). In conclusion, this study showed the feasibility and potential of using 23Na-MRI in renal tumours to probe sodium concentrations. These preliminary findings suggest a differential sodium content between benign ROs and malignant chRCCs. The inverse correlation between sodium concentration and 1H-R2* as a surrogate of hypoxia may indicate a biophysical relationship between the two which requires further validation in larger patient cohorts.

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Cite This Study

Gallagher et al. (Fri,) studied this question.

synapsesocial.com/papers/6a250ae37def13d035e1af8d https://doi.org/https://doi.org/10.17863/cam.130754

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