Renal cell carcinoma CT: Difference between revisions
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__NOTOC__ | |||
{{Renal cell carcinoma}} | {{Renal cell carcinoma}} | ||
{{CMG}} {{AE}} {{F.K}} {{Rim}} | |||
==Overview== | ==Overview== | ||
Renal CT scan may be helpful in the diagnosis of renal cell carcinoma. CT may be used to detect [[neoplastic]] masses that may define renal cell carcinoma or [[metastasis]] of primary cancer. | |||
==Computed Tomography== | |||
Renal CT scan may be helpful in the diagnosis of renal cell carcinoma. CT may be used to detect [[neoplastic]] masses that may define renal cell carcinoma or [[metastasis]] of the primary cancer. CT scan and use of intravenous (IV) [[contrast]] is generally used for work-up and follow-up of patients with renal cell carcinoma.<ref name="pmid16339096">{{cite journal| author=Cohen HT, McGovern FJ| title=Renal-cell carcinoma. | journal=N Engl J Med | year= 2005 | volume= 353 | issue= 23 | pages= 2477-90 | pmid=16339096 | doi=10.1056/NEJMra043172 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16339096 }} </ref> <ref name="pmid20479778">{{cite journal |vauthors=Leveridge MJ, Bostrom PJ, Koulouris G, Finelli A, Lawrentschuk N |title=Imaging renal cell carcinoma with ultrasonography, CT and MRI |journal=Nat Rev Urol |volume=7 |issue=6 |pages=311–25 |date=June 2010 |pmid=20479778 |doi=10.1038/nrurol.2010.63 |url=}}</ref><br> The following guidelines of the American Urological Association in 2013 state the following regarding the use of CT in renal cell carcinoma: | |||
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{| | |||
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |'''''Use of CT in Renal Cell Carcinoma<ref name="pmid23665399">{{cite journal| author=Donat SM, Diaz M, Bishoff JT, Coleman JA, Dahm P, Derweesh IH et al.| title=Follow-up for Clinically Localized Renal Neoplasms: AUA Guideline. | journal=J Urol | year= 2013 | volume= 190 | issue= 2 | pages= 407-16 | pmid=23665399 | doi=10.1016/j.juro.2013.04.121 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23665399 }} </ref>''''' | |||
|- | |||
! style="background:#7d7d7d; color: #FFFFFF;" align="center" + |'''Patient Profile''' | |||
! style="background:#7d7d7d; color: #FFFFFF;" align="center" + |'''Use of CT''' | |||
! style="background:#7d7d7d; color: #FFFFFF;" align="center" + |'''Evidence Strength'' | |||
|- | |||
| style="background:#DCDCDC;" + |'''Low Risk Patient (pT1, N0, Nx)''' | |||
| style="background:#F5F5F5;" + |Baseline abdominal CT (or MRI) for nephron sparing surgery and CT (or US or MRI) for radical nephrectomy within 3-12 months following renal surgery <br><br>Additional CT (or US or MRI) may be performed in patients following radical nephrectomy if initial post-op baseline image is negative | |||
| style="background:#F5F5F5;" align="center" + |Expert opinion<br>C | |||
|- | |||
| style="background:#DCDCDC;" + |'''Moderate to High Risk Patients (pT2-4N0 Nx or any stage N+)''' | |||
| style="background:#F5F5F5;" + |Baseline chest and abdominal CT (or MRI) within 3-6 months following surgery with continued imaging (US, CXR, CT, or MRI) every 6 months for at least 3 years and annually thereafter to 5 years. Site specific imaging is warranted by clinical symptoms suggestive of recurrence or metastatic spread. Imaging (US, CXR, CT, or MRI) beyond 5 years may be performed at the discretion of the clinician | |||
| style="background:#F5F5F5;" align="center" + |C | |||
|- | |||
| style="background:#DCDCDC;" + |'''Active surveillance''' | |||
| style="background:#F5F5F5;" + |Cross-sectional abdominal scanning (CT or MRI) within 6 months of active surveillance initiation to establish a growth rate. Further imaging is recommended at least annually thereafter | |||
| style="background:#F5F5F5;" align="center" + |C | |||
|- | |||
| style="background:#DCDCDC;" + |'''Ablation ''' | |||
| style="background:#F5F5F5;" + |Patients undergo cross-sectional CT or MRI with and without IV contrast unless contraindicated at 3 and 6 months following ablative therapy to assess treatment success. Annual abdominal CT or MRI should follow for 5 years. Individual CT (or MRI) beyond 5 years is based on individual patient risk factors | |||
| style="background:#F5F5F5;" align="center" + | C | |||
|} | |||
<sup><center>Adapted from Donat SM et al. Follow-up for clinically localized renal neoplasms: AUA guideline. ''J Urol''. 2013; 190(2):407-16. </center> | |||
[[File:Hypovascular-renal-cell-carcinoma.jpg|300px|thumb|left|CT scan showing renal cell carcinoma [https://radiopaedia.org/cases/hypovascular-renal-cell-carcinoma source:Case courtesy of Dr Roberto Schubert, Radiopaedia.org, rID: 16088]]] | |||
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[[File:Transitional-cell-carcinoma-of-the-renal-pelvis.jpg|300px|thumb|left|CT scan showing renal cell carcinoma [https://radiopaedia.org/cases/https://radiopaedia.org/cases/transitional-cell-carcinoma-of-the-renal-pelvis source:Case courtesy of Dr Roberto Schubert, Radiopaedia.org, rID: 14163]]] | |||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Kidney diseases]] | |||
[[Category:Types of cancer]] | |||
[[Category:Nephrology]] | |||
[[Category:Mature chapter]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Medicine]] | |||
[[Category:Nephrology]] | |||
[[Category:Surgery]] | |||
Latest revision as of 16:47, 11 December 2018
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Renal cell carcinoma Microchapters |
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Renal cell carcinoma CT On the Web |
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American Roentgen Ray Society Images of Renal cell carcinoma CT |
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Risk calculators and risk factors for Renal cell carcinoma CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farima Kahe M.D. [2] Rim Halaby, M.D. [3]
Overview
Renal CT scan may be helpful in the diagnosis of renal cell carcinoma. CT may be used to detect neoplastic masses that may define renal cell carcinoma or metastasis of primary cancer.
Computed Tomography
Renal CT scan may be helpful in the diagnosis of renal cell carcinoma. CT may be used to detect neoplastic masses that may define renal cell carcinoma or metastasis of the primary cancer. CT scan and use of intravenous (IV) contrast is generally used for work-up and follow-up of patients with renal cell carcinoma.[1] [2]
The following guidelines of the American Urological Association in 2013 state the following regarding the use of CT in renal cell carcinoma:
| Use of CT in Renal Cell Carcinoma[3] | ||
|---|---|---|
| Patient Profile | Use of CT | 'Evidence Strength |
| Low Risk Patient (pT1, N0, Nx) | Baseline abdominal CT (or MRI) for nephron sparing surgery and CT (or US or MRI) for radical nephrectomy within 3-12 months following renal surgery Additional CT (or US or MRI) may be performed in patients following radical nephrectomy if initial post-op baseline image is negative |
Expert opinion C |
| Moderate to High Risk Patients (pT2-4N0 Nx or any stage N+) | Baseline chest and abdominal CT (or MRI) within 3-6 months following surgery with continued imaging (US, CXR, CT, or MRI) every 6 months for at least 3 years and annually thereafter to 5 years. Site specific imaging is warranted by clinical symptoms suggestive of recurrence or metastatic spread. Imaging (US, CXR, CT, or MRI) beyond 5 years may be performed at the discretion of the clinician | C |
| Active surveillance | Cross-sectional abdominal scanning (CT or MRI) within 6 months of active surveillance initiation to establish a growth rate. Further imaging is recommended at least annually thereafter | C |
| Ablation | Patients undergo cross-sectional CT or MRI with and without IV contrast unless contraindicated at 3 and 6 months following ablative therapy to assess treatment success. Annual abdominal CT or MRI should follow for 5 years. Individual CT (or MRI) beyond 5 years is based on individual patient risk factors | C |
References
- ↑ Cohen HT, McGovern FJ (2005). "Renal-cell carcinoma". N Engl J Med. 353 (23): 2477–90. doi:10.1056/NEJMra043172. PMID 16339096 Check
|pmid=value (help). - ↑ Leveridge MJ, Bostrom PJ, Koulouris G, Finelli A, Lawrentschuk N (June 2010). "Imaging renal cell carcinoma with ultrasonography, CT and MRI". Nat Rev Urol. 7 (6): 311–25. doi:10.1038/nrurol.2010.63. PMID 20479778.
- ↑ Donat SM, Diaz M, Bishoff JT, Coleman JA, Dahm P, Derweesh IH; et al. (2013). "Follow-up for Clinically Localized Renal Neoplasms: AUA Guideline". J Urol. 190 (2): 407–16. doi:10.1016/j.juro.2013.04.121. PMID 23665399.