Genitourinary Clinical Protocols: Routine Renal Mass














New York University School of Medicine Department of Radiology
Suggestions/Comments

Genitourinary Clinical Protocols

Routine Renal Mass

Updated 1/2003

Phased array coil centered over kidneys.

Weight based Gadolinium contrast (*), 15cc if pt is less than 180 pounds; otherwise 20cc Gd

Assess the patient’s breath holding capability. If poor capability, give oxygen. If the patient can’t hold his/her breath call body radiologist.

Run sequences in the order listed.

Sequence	Plane	Comment	Film #
T1 in/out	Ax		1
HASTE	Cor	No fat sat. 5-6mm slices	1
VIBE	Ax	Slab thickness to include kidneys and entire mass.	0
3D FLASH	Cor	Try to get effective thickness 2mm. Thin slab cover only renal arteries.	0
Give Lasix		If the mass is near the hilum / collecting system. Dose: 1mg (1cc from standard 10cc vial)
Timing Run	Ax	Thru kidneys – 1cc at 2cc/sec followed by 20 cc saline at 2cc/sec	0
3D FLASH	Cor	1 measures (0 sec) Use standard timing formula.	0
VIBE	Ax	Hx prior. (2 measures 70, 180 s)	1
3D FLASH (optional)	Cor	Delayed Urogram if requested , if not do delayed VIBE	0
VIBE	Cor	7-10 minute delayed	0
Do Subtractions		1-Arterial phase – pre-contrast, 2-vibe post-pre	0
Do Subtraction		Delayed urogram – pre-contrast	0

(*) The use of gadolinium contrast material for these applications represents off-label usage in the U.S. Outside the U.S., please consult your country's regulations for local guidelines.

NOTE: These protocols apply to Siemens Symphony (with Quantum gradients) and Sonata systems. While they reflect the protocols used at NYU Medical Center, NYU is not responsible for their application elsewhere.