Non-Contrast Perfusion Using Arterial Spin Labeled MR Imaging for Assessment of Therapy Response in Metastatic Renal Cell Carcinoma

Inclusion Criteria:

* Patients with locally advanced or metastatic renal cell carcinoma.
* Patients scheduled to undergo anti-angiogenic treatment or immunotherapy
* Eastern Cooperative Oncology Group (ECOG) Status 0, 1 and 2.
* Women of child-bearing potential must agree to undergo a urine pregnancy screening per standard Radiology departmental protocol, in place to prevent imaging of pregnant patients. A female of child-bearing potential is any woman (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria: 1) Has not undergone a hysterectomy or bilateral oophorectomy; or 2) Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months).
* Ability to understand and the willingness to sign a written informed consent.

Exclusion Criteria:

* Subjects may not be receiving any other anti-angiogenic agents, at the time of enrollment.
* Subjects must not be pregnant since pregnancy is a contraindication to administration of gadolinium-based contrast agents.
* Any contraindication to MRI per Radiology Department's routine protocol, e.g. MRI-incompatible objects, including but not limited to medical devices (e.g. pacemakers, automated implantable cardioverter defibrillators, etc.) and other foreign bodies.
* Known severe allergic reaction to Gadolinium-based contrast agents.
* Patients with sickle cell disease and patients with other hemolytic anemias (low red blood count in body).
* Patients with uncontrollable claustrophobia, severe lower back pain, and uncontrollable tremors, to the point that it would render them unable to tolerate an MRI study.