Solid Renal Mass MRI Report Generator

A standardized reporting template that applies the clear cell likelihood score (ccLS) algorithm.
To see a visual flowchart of the ccLS algorithm go here
For non-commercial and non-clinical purposes only. Use at your own risk.

Fields required to generate a clear cell likelihood score are denoted with the symbol which dynamically appears/disappears based upon inputs.

This algorithm is designed for solid (≥25% enhancing component) renal masses without macroscopic (bulk) fat.
Please use the Bosniak classification for cystic (non-solid) masses.

Size of the mass

(AP) x (LL) x (CC) cm

Is prior imaging available?

Location of the mass

Laterality:

Along CC dimension:

Along LL dimension:

Along AP dimension:

Depth Extension

T2 Signal Intensity  

Assess T2 signal ONLY in enhancing component of tumor

Intensity Relative to Background Renal Cortex

Pattern of T2 Signal

Enhancement Characteristics at Corticomedullary (CM) Phase  

Assess area with the HIGHEST enhancement on CM phase

Degree of Enhancement Relative to Background Renal Cortex

Pattern of Enhancement

T1 Chemical Shift

Diffusion Weighted Imaging (DWI) Characteristics

Assess on high b-value DWI sequence (i.e. 800 sec/mm2)

DWI Signal Relative to Background Renal Cortex

Apparent Diffusion Component (ADC) Map Signal Relative to Background Renal Cortex

Is Segmental Enhancement Inversion (SEI) Present?  

Is Tumor Washout Present?

(i.e., Arterial-Delayed Enhancement Ratio (ADER) ≥ 1.5)

MRI Staging

Renal Vein Anatomy

Renal Vein Thrombus

Renal Artery Anatomy

Generate the Report:

Findings:

___ Kidney:
- Size: ___
- Location: ___; ___; ___.
- Depth extension: ___.
- T2 signal relative to renal cortex: ___; ___.
- T1 chemical shift: ___
- High b-value DWI: ___; ADC: ___.
- Enhancement (corticomedullary) relative to renal cortex: ___; ___.
- Segmental Inversion Enhancement: ___.
- Clear cell RCC Likelihood Score (ccLS; 1-5): ___.
- Fat Poor AML suspected: ___.
- Oncocytoma suspected: ___.
- MR Staging: ___.
- Renal vein anatomy: ___.
- Renal vein thrombus: ___.
- Renal artery anatomy (ipsilateral): ___.

Impression:

A ___ cm, stage ___ enhancing solid ___ renal mass. MRI findings ___.

References

  1. Pedrosa I, Cadeddu JA. How We Do It: Managing the Indeterminate Renal Mass with the MRI Clear Cell Likelihood Score. Radiology. 2021 Dec 14;210034. doi: 10.1148/radiol.210034
  2. Kay FU, Pedrosa I. Imaging of Solid Renal Masses. Radiol Clin North Am. 2017;55(2):243-58. doi: 10.1016/j.rcl.2016.10.003
  3. Canvasser NE, Kay FU, Xi Y, Pinho DF, Costa D, Diaz de Leon A, Khatri G, Leyendecker JR, Yokoo T, Lay A, Kavoussi N, Koseoglu E, Cadeddu JA, Pedrosa I. Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging to Identify Clear Cell Renal Cell Carcinoma in cT1a Renal Masses. J Urol. 2017;198(4):780-6. doi: 10.1016/j.juro.2017.04.089
  4. Diaz de Leon A, Davenport MS, Silverman SG, Schieda N, Cadeddu JA, Pedrosa I. Role of Virtual Biopsy in the Management of Renal Masses. AJR Am J Roentgenol. 2019:1-10. doi: 10.2214/AJR.19.21172