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Developing novel imaging methods to characterise and stratify indeterminate kidney tumours at an early stage has the potential to address this clinical challenge. Here we applied sodium MRI (\n                    <jats:sup>23<\/jats:sup>\n                    Na\u2010MRI) to estimate kidney tumour sodium content in a prospectively recruited case series of 10 patients (mean age\u2009\u00b1\u2009SD 64\u2009\u00b1\u20098\u2009years; 7:3 male:female ratio). The patients had localised renal tumours which included six renal oncocytomas (ROs), two chromophobe renal cell carcinomas (chRCCs), three clear cell RCCs (ccRCC) and one papillary RCC (pRCC). The patients underwent\n                    <jats:sup>23<\/jats:sup>\n                    Na\u2010MRI at 3\u2009T (3D sodium cones and double\u2010angle B\n                    <jats:sub>1<\/jats:sub>\n                    mapping) and\n                    <jats:sup>1<\/jats:sup>\n                    H\u2010MRI which included\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sub>2<\/jats:sub>\n                    * mapping and intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI). The following imaging parameters were quantified within the renal tumours and in the normal\u2010appearing kidney parenchyma: apparent total sodium concentration (TSC); apparent\n                    <jats:sup>23<\/jats:sup>\n                    Na and\n                    <jats:sup>1<\/jats:sup>\n                    H relaxation rates (\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sub>2<\/jats:sub>\n                    *); perfusion fraction (\n                    <jats:italic>f<\/jats:italic>\n                    <jats:sub>p<\/jats:sub>\n                    ); and diffusion coefficient (\n                    <jats:italic>D<\/jats:italic>\n                    <jats:sub>t<\/jats:sub>\n                    ).\n                    <jats:sup>23<\/jats:sup>\n                    Na\u2010MRI findings were correlated with conventional\n                    <jats:sup>1<\/jats:sup>\n                    H\u2010MRI measures of perfusion, hypoxia and cellularity. The mean apparent TSC in ccRCC and in pRCC were 135\u2009\u00b1\u200959\u2009mM and 81\u2009mM, respectively. The apparent TSC was significantly higher in ROs compared to chRCCs: 162\u2009\u00b1\u200958\u2009mM vs. 71\u2009\u00b1\u20092\u2009mM (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). The apparent TSC inversely correlated with\n                    <jats:sup>1<\/jats:sup>\n                    H\u2010\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sub>2<\/jats:sub>\n                    * (Spearman r\u2009=\u2009\u22120.39,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). In conclusion, this study showed the feasibility and potential of using\n                    <jats:sup>23<\/jats:sup>\n                    Na\u2010MRI in renal tumours to probe sodium concentrations. These preliminary findings suggest a differential sodium content between benign ROs and malignant chRCCs. The inverse correlation between sodium concentration and\n                    <jats:sup>1<\/jats:sup>\n                    H\u2010\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sub>2<\/jats:sub>\n                    * as a surrogate of hypoxia may indicate a biophysical relationship between the two which requires further validation in larger patient cohorts.\n                  <\/jats:p>","DOI":"10.1002\/nbm.70338","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T09:12:52Z","timestamp":1782292372000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimating the Sodium Content: A Case Series of Benign and Malignant Renal Tumours Using\n                    <sup>23<\/sup>\n                    Na\u2010MRI at 3\u2009T"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1373-6944","authenticated-orcid":false,"given":"Ines","family":"Horvat\u2010Menih","sequence":"first","affiliation":[{"name":"Department of Radiology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3920-4038","authenticated-orcid":false,"given":"Jonathan R.","family":"Birchall","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria J.","family":"Zamora\u2010Morales","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Bebb","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6706-3442","authenticated-orcid":false,"given":"Joshua D.","family":"Kaggie","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Riemer","sequence":"additional","affiliation":[{"name":"Mohn Medical Imaging and Visualization Centre, Department of Radiology Haukeland University Hospital Helse Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew B.","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Cambridge  Cambridge UK"},{"name":"Department of Radiology Royal Papworth Hospital  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew N.","family":"Priest","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Cambridge  Cambridge UK"},{"name":"Department of Radiology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Wylot","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iosif A.","family":"Mendichovszky","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Cambridge  Cambridge UK"},{"name":"Department of Radiology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Y.","family":"Warren","sequence":"additional","affiliation":[{"name":"Department of Pathology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust  Cambridge"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2194-4903","authenticated-orcid":false,"given":"James","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Oncology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James N.","family":"Armitage","sequence":"additional","affiliation":[{"name":"Department of Urology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0761-9503","authenticated-orcid":false,"given":"Thomas J.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Urology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"},{"name":"Department of Surgery University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3188-9140","authenticated-orcid":false,"given":"Grant D.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Urology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"},{"name":"Department of Surgery University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary A.","family":"McLean","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4784-5230","authenticated-orcid":false,"given":"Ferdia A.","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Cambridge  Cambridge UK"},{"name":"Department of Radiology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation 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Value of Blood Oxygenation Level\u2010Dependent (BOLD) MR Imaging in Differentiation of Renal Solid Mass and Grading of Renal Cell Carcinoma (RCC): Analysis Based on the Largest Cross\u2010Sectional Area Versus the Entire Whole Tumour","volume":"10","author":"Wu G.","year":"2015","journal-title":"PLoS ONE"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.28517"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.26340"},{"key":"e_1_2_14_14_1","volume-title":"Brenner & Rector's the Kidney","author":"Taal M. 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