MRI chief Pedrosa helps develop algorithm to bypass biopsy

Dr. Ivan Pedrosa and Dr. Jeffrey Cadeddu
Dr. Ivan Pedrosa and Dr. Jeffrey Cadeddu (foreground)

Dr. Ivan Pedrosa and Dr. Jeffrey Cadeddu have developed a diagnostic algorithm used with current magnetic resonance imaging (MRI) technology to interpret renal masses, allowing physicians to determine whether kidney tumors are benign or malignant without having to perform a biopsy.

Dr. Pedrosa, Professor of Radiology and Chief of MRI, and Dr. Cadeddu, an 18-year veteran urologist, co-authored a study published in The Journal of Urology on the diagnostic accuracy of multiparametric MRI (mpMRI) protocols in assessing the chemical composition of tumors.

“Using mpMRI, multiple types of images can be obtained from the renal mass and each one tells us something about the tissue,” Dr. Pedrosa said, noting that T2-weighted images and those immediately after intravenous dye reaches the kidney are leveraged, as well as other images that indicate whether fat is present in the tumor. “This gives doctors a four-in-five chance of identifying clear cell cancer.”

Clear cell Renal Cell Carcinoma (ccRCC), which accounts for about 70 percent of kidney cancers, is the most aggressive form of the disease. 

“A clear cell likelihood score used with magnetic resonance imaging can reasonably identify clear cell histology in small renal masses and may decrease the number of diagnostic renal mass biopsies,” the authors conclude.

“Biopsies are not entirely free of pain and discomfort,” Dr. Cadeddu said. “Some patients, in fact, choose to observe the cancer simply to avoid the pain of the biopsy. If we can avoid the anxiety and the fear and the rare, but possible complication of a biopsy, I think we’re pushing medicine forward.”

Their research is supported by a Specialized Program of Research Excellence (SPORE) award from the National Cancer Institute, one of two such awards for kidney cancer in the nation. Both researchers are co-leaders of UT Southwestern's Kidney Cancer Program.