Imaging Correlates of Renal Cell Carcinoma Biological Features

This pilot study is designed to evaluate imaging parameters indicative of underlying tumor
biology. Patients with large renal masses (>3 cm, or at the discretion of the investigator)
who are planning to undergo nephrectomy will be identified, and recruited to undergo a
contrast-enhanced magnetic resonance-Fluorodeoxyglucose-positron emission tomography
(MR-FDG-PET) scan. Samples collected from their tumor after it is removed will undergo a
variety of laboratory tests, including biomarker assessments and genotyping. By examining
primary renal masses via a combination of MR and FDG-PET functional imaging in concert with
tissue based tests, areas of hypermetabolism and hypervascularization will be evaluated as
features of HIF activation or tumor subtype.

Inclusion Criteria:

- ≥ 18 years of age (no upper age limit)

- Informed consent obtained and signed

- Clinically suspected RCC based on imaging performed prior to enrollment

- Planned nephrectomy schedule that can accommodate a MR-FDG-PET scan within 4 weeks
prior to surgery

- Willing to undergo gadolinium enhanced MRI with simultaneous acquisition of FDG-PET
uptake by the tumor within 4 weeks prior to nephrectomy

- Willing to consent for genetic and proteomic analysis of tumor and germline nucleic
acids

- Women of childbearing potential must have a negative serum or urine pregnancy test
performed within 7 days prior to FDG-PET-MRI

- Breast feeding women cannot do so for 24 hours after FDG injection

- Patient is willing to fast for 4 hours, including avoiding any sugar-containing
drinks.

- Patient is willing to drink at least 32 ounces of water (or other no-sugar-containing
fluids) within 4 hours prior to arriving for scans.

Exclusion Criteria:

- History of severe reaction to gadolinium-enhanced MRI

- Poorly controlled diabetes mellitus

- Inability to tolerate PET and/or MRI

- Presence of pacemaker or intracranial aneurysm clip

- GFR < 30mL/min as measured via Cockcroft-Gault equation

- Inability to lie flat for >1 hour

- Pregnant female

- History of a prior malignancy within past 5 years are excluded unless they have been
disease free for 3 or more years or unless they have a completely resected
non-melanoma skin cancer, low risk prostate cancer, or other low risk tumor history at
the discretion of the investigator.

- Substance abuse, medical, psychological, or social conditions that may interfere with
the patient's participation in the study