Multiparametric MRI (mpMRI) for Preoperative Staging and Treatment Planning for Newly-Diagnosed Prostate Cancer (PI: Ersan Altun)

Purpose: The purpose of this research study is to test if a new MRI imaging exam called mpMRI combined with PIRADSv2 is useful for evaluating prostate cancer in finding aggressive disease.

Participants: There will be about 852 prostate cancer patients undergoing surgery taking part in this research study.

Procedures (methods): All research study participants will have the mpMRI imaging as part of their prostate cancer evaluation and the radiologists will all use PIRADSv2 when reading their scans.

Cross-Sectional Study of Contrast-Enhanced Ultrasound with Lumason/Definity as a Screening Tool for Kidney Cancer in Patients with Von Hippel-Lindau (PI: Emily Chang)

Purpose: To determine if contrast-enhanced ultrasound can detect abnormal features of kidney lesions in patients with Von-Hippel Lindau with the same accuracy as conventional ultrasound and contrast-enhanced magnetic resonance imaging.

Participants: Patients with Von-Hippel Lindau who are undergoing annual abdominal imaging surveillance.

Procedures (methods): Patients with Von-Hippel Lindau undergoing annual abdominal imaging surveillance will be recruited. All consented subjects will obtain contrast-enhanced ultrasound. Images will be de-identified, and read by radiologists (3) who are blinded to patient clinical information. They will use the Bosniak criteria for cystic lesions to categorize lesions. Contrast-enhanced ultrasound diagnosis will be compared to B-mode ultrasound (obtained at the same time as contrast-enhanced ultrasound) and contrast-enhanced MRI (performed within 4 months of contrast-enhanced ultrasound) diagnosis to determine the rate of agreement. Gold standard: contrast-enhanced MRI Standard of care: contrast-enhanced MRI and conventional US.

Contrast-enhanced Ultrasound for Complex Kidney Lesion Diagnosis in Patients with CKD extension (CEUS CKDx) (PI: Emily Chang)

Purpose: The primary objective of the study is to estimate the sensitivity of CEUS in diagnosing kidney malignancy in patients with a risk factor for kidney malignancy and compare it to the current gold standard test in this patient population. Secondary analysis will include more optimal contrast-enhanced imaging with computed tomography (CT) or magnetic resonance imaging (MRI) in a subset of patients who can receive these studies. The study outcome will lead to immediate clinical application in patients with chronic kidney disease. Given the cost-effectiveness and adverse event profile, it has excellent potential to become established as first line diagnostics in the general patient population as well.

Participants: This study will recruit to a target goal of 20 patients with kidney disease and a suspicious kidney lesion.  We will also include 5 healthy volunteers for imaging optimization and 3 controls subjects.  The healthy volunteers will be individuals without any lesions.  The control subjects will be individuals that meet the study inclusion, but decline imaging and allow for their lab values to be followed for the study duration.

Procedures (methods): This is an investigator-initiated, prospective study designed to evaluate the accuracy of contrast-enhanced ultrasound (CEUS) with microbubble contrast agent (perflutren lipid; Definity®) to identify malignancy in patients with kidney disease, a known risk factor for kidney malignancy, in whom a conventional ultrasound (US) or other prior imaging shows an indeterminate or suspicious kidney lesion.

Contrast-Enhanced Ultrasound for Complex Kidney Lesion Diagnosis (CEUS CKD) (PI: Emily Chang)

Purpose: The primary objective of the study is to estimate the sensitivity of CEUS in diagnosing kidney malignancy in patients with a risk factor for kidney malignancy and compare it to the current gold standard test in this patient population. Secondary analysis will include more optimal contrast-enhanced imaging with computed tomography (CT) or magnetic resonance imaging (MRI) in a subset of patients who can receive these studies. The study outcome will lead to immediate clinical application in patients with chronic kidney disease. Given the cost-effectiveness and adverse event profile, it has excellent potential to become established as first line diagnostics in the general patient population as well.

Participants:  This study will recruit to a target goal of 75 patients with kidney disease between the primary site (UNC) and Affiliate (VU).

Procedures (methods): This is an investigator-initiated, prospective study designed to evaluate the accuracy of contrast-enhanced ultrasound (CEUS) with microbubble contrast agent (perflutren lipid; Definity®) to identify malignancy in patients with kidney disease, a known risk factor for kidney malignancy, in whom a conventional ultrasound (US) shows an indeterminate cystic kidney lesion

Novel MRI Sequence- MR Fingerprinting (PI: William Hyslop)

Purpose: The purpose of this study is to evaluate novel quantitative MRI techniques in clinical studies to determine whether they can provide better, faster and more useful information for clinical diagnosis. In this study, we propose to apply MR Fingerprinting at UNC and evaluate its performance for different diseases. These include but not limited to diseases in liver, kidney, cardiac, pancreas etc. We hypothesis that the quantitative MR imaging technique will lead to improved tissue characterization and diagnosis.

Participants:  Approximately 100 patients at UNC that receive an MRI will be recruited. There will be an additional 5 healthy male volunteers to practice using the sequence prior to imaging clinical patients.

Procedures:  A novel MR technique less than 15 minutes will be added to the standard MRI sequence here at UNC.