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This prospective proof-of-concept study evaluates kidney MR fingerprinting (MRF) alone and combined with diffusion-weighted imaging and arterial spin labeling (ASL) MRI to distinguish indolent from aggressive tumors. Adults with suspected renal cell carcinoma underwent noncontrast coronal T1/T2 MRF at 3.0T plus ADC and renal blood flow measurements. Histopathology served as the reference standard, and multivariable analysis showed complementary MRF-derived T1 and T2 performance for differentiation.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/noninvasive-differentiation-of-indolent-from-aggressive-renal-neoplasms-with-mr-fingerprinting-combined-with-diffusionperfusion-mri/357455/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/noninvasive-differentiation-of-indolent-from-aggressive-renal-neoplasms-with-mr-fingerprinting-combined-with-diffusionperfusion-mri/357455.png","ImageObject",300,407,{"name":92,"@type":93},"Well Done","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What imaging approach does the study evaluate for differentiating renal tumors?","Question",{"text":113,"@type":114},"It evaluates kidney MR fingerprinting (MRF) alone and combined with diffusion-weighted imaging and arterial spin labeling (ASL) MRI, using ADC and renal blood flow measures for characterization.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were tumors classified in this research?",{"text":118,"@type":114},"Histopathologic grading served as the reference standard, classifying renal masses as indolent (low-grade or benign) versus aggressive (high-grade or unclassified RCC) based on biologic behavior.",{"name":120,"@type":111,"acceptedAnswer":121},"What were the key findings on diagnostic performance?",{"text":122,"@type":114},"While between-group differences were observed in T2, no evidence of differences was seen in T1, ADC, or renal blood flow alone. Multivariable analysis combining MRF-derived T1 and T2 achieved an AUC of 0.89 in this exploratory setting.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},357455,1790174731,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},5909892210082,"https://ap-avatar.wpscdn.com/avatar/56001069da27c9f41e8?x-image-process=image/resize,m_fixed,w_180,h_180&k=1789614185077863061","Author Manuscript Author Manuscript Author Manuscript Author Manuscript  \n\n| | HHS Public Access\u003Cbr>Author manuscript\u003Cbr>Radiology. Author manuscript; available in PMC 2026 July 06. |\n| --- | --- |\n\nPublished in final edited form as:  \nRadiology. 2026 March ; 318(3): e251404 . doi:10.1148/radiol.251404 .  \nNoninvasive Differentiation of Indolent from Aggressive Renal Neoplasms with MR Fingerprinting Combined with Diffusion/ Perfusion MRI  \nSree Harsha Tirumani, MD 1,2 , Christina J. MacAskill, BS3 , Yilun Sun, PhD4 , Dheeman Futela, MD 1 , Holly Harper, MD5,6 , Adam Calaway, MD7,8 , Bernd Kuehn, PhD9 , Ke Cheng Liu, PhD 10 , Lee Ponsky, MD7,8 , Mark Griswold, PhD 1,2 , Chris A. Flask, PhD 1,2,3,11,12 , Yong Chen, PhD 1,2  \n1 Department of Radiology, Case Western Reserve University, 11100 Euclid Ave, Bolwell Bldg, Room B120, Cleveland, OH 44106  \n2 Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio  \n3 Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio  \n4 Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio  \n5 Department of Pathology, Case Western Reserve University, Cleveland, Ohio  \n6 Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio  \n7 Department of Urology, Case Western Reserve University, Cleveland, Ohio  \n8 Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, Ohio  \n9MR Application Predevelopment, Siemens Healthineers, Erlangen, Germany  \n10Siemens Medical Solutions USA, Malvern, Pa  \n11 Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio  \n12 Department of Pediatrics, University Hospitals Cleveland Medical Center, Cleveland, Ohio  \nAbstract  \nPublished by the Radiological Society of North America under a CC BY 4.0 license.  \nAddress correspondence to: Y.C. ([yxc235@case.edu](yxc235@case.edu)).  \nAuthor contributions: Sree Harsha Tirumani: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing-original draft, Writing-review & editing; Christina J. MacAskill: Data curation, Investigation, Methodology, Software; Yilun Sun: Data curation, Formal analysis, Investigation, Methodology, Software, Validation, Writing-original draft, Writing-review & editing; Dheeman Futela:  \nData curation, Formal analysis, Investigation, Methodology, Software, Validation, Visualization; Holly Harper: Data curation, Formal analysis, Investigation, Visualization; Adam Calaway: Conceptualization, Data curation, Investigation; Bernd Kuehn: Methodology; Ke Cheng Liu: Methodology; Lee Ponsky: Data curation, Investigation; Mark Griswold: Funding acquisition, Investigation, Methodology, Resources, Software; Chris A. Flask: Conceptualization, Data curation, Investigation, Methodology, Project administration, Resources, Supervision, Writing-original draft, Writing-review & editing; and Yong Chen: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing-original draft, Writing-review & editing.  \nDisclosures of conflicts of interest: Please see ICMJE form(s) for author conflicts of interest. These have been provided as supplemental materials.  \nAuthor Manuscript Author Manuscript Author Manuscript Author Manuscript  \nTirumani et al. Page 2  \nBackground: Accurate characterization of tumor grade and aggressiveness for renal neoplasms with noninvasive imaging methods is critical for patient management and outcome.  \nPurpose: To evaluate kidney MR fingerprinting (MRF) alone and in combination with diffusionweighted imaging and arterial spin labeling (ASL) MRI for the diagnosis and characterization of renal neoplasms by assessing its performance in differentiating indolent from aggressive t","cbCaik795bU0HVYH","https://ap.wps.com/l/cbCaik795bU0HVYH","pdf",1340740,22,"English","# Background\n# Purpose\n# Materials and Methods\n## Participants and reference standard\n## Imaging and analysis\n# Results\n# Conclusion","[{\"question\":\"What imaging approach does the study evaluate for differentiating renal tumors?\",\"answer\":\"It evaluates kidney MR fingerprinting (MRF) alone and combined with diffusion-weighted imaging and arterial spin labeling (ASL) MRI, using ADC and renal blood flow measures for characterization.\"},{\"question\":\"How were tumors classified in this research?\",\"answer\":\"Histopathologic grading served as the reference standard, classifying renal masses as indolent (low-grade or benign) versus aggressive (high-grade or unclassified RCC) based on biologic behavior.\"},{\"question\":\"What were the key findings on diagnostic performance?\",\"answer\":\"While between-group differences were observed in T2, no evidence of differences was seen in T1, ADC, or renal blood flow alone. Multivariable analysis combining MRF-derived T1 and T2 achieved an AUC of 0.89 in this exploratory setting.\"}]","Noninvasive Differentiation of Indolent from Aggressive Renal Neoplasms with MR Fingerprinting Combined with Diffusion/Perfusion MRI | PDF",1790130058,55]