Comparison of Hyperpolarized 13C Pyruvate MRI and 1H MRI for Predicting Renal Tumor Aggressiveness

Motivation: Current imaging methods have limitations in predicting localized renal tumor aggressiveness. Goal(s): Comparing the performance of predicting high grade ccRCCs, typically considering as aggressive RCCs, by different MR imaging methods. Approach: We compared the performance of hyperpolarized 13C pyruvate MRI and 1H MRI for predicting high-grade ccRCCs in 22 localized renal tumors. Results: Hyperpolarized 13C-labelled lactate-to-pyruvate ratio was significantly higher in high-grade ccRCCs compared to other renal tumor group(benign renal tumors, chromophobe RCCs, and low grade ccRCCs, P=0.003). Neither the percentage signal intensity change from contrast-enhanced MRI nor the apparent diffusion coefficient from diffusion-weighted MRI was able to differentiate between the two groups. Impact: Compared to 1H MRI, HP 13C MRI enables improved prediction of high-grade clear cell renal cell carcinomas.