Renal cell carcinoma MRI: Difference between revisions
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{{Renal cell carcinoma}} | {{Renal cell carcinoma}} | ||
Similar to CT, an MRI may be used to diagnose and for follow-up of renal cell carcinoma. Due to the use of IV gadolinium in MRI, the risk of nephrogenic systemic fibrosis (NSF) must always be considered. It is a rare condition that often has cutaneous manifestations, but may affect any organ. Risk factors for development of NSF are as follows: | |||
*High dose of gadolinium-based contrast | |||
*Acute and chronic renal failure | |||
*Vascular injury | |||
{|border="1" style="border-collapse:collapse; text-align:left;" cellpadding="5" 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>''''' | |||
| bgcolor="#d9ff54"|'''Patient Profile''' || bgcolor="#d9ff54"|'''Use of MRI'''||bgcolor="#d9ff54"|'''Evidence Strength''' | |||
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| bgcolor="#ececec"|'''Low Risk Patient (pT1, N0, Nx)''' ||Baseline abdominal MRI (or CT) for nephron sparing surgery and CT (or US or MRI) for radical nephrectomy within 3-12 months following renal surgery <br><br>Additional MRI (or US or CT) may be performed in patients following radical nephrectomy if initial post-op baseline image is negative||Expert opinion <br><br>C | |||
|- | |||
| bgcolor="#ececec"|'''Moderate to High Risk Patients (pT2-4N0 Nx or any stage N+)'''||Baseline chest and abdominal MRI (or CT) 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 | |||
|- | |||
| bgcolor="#ececec"|'''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 | |||
|- | |||
| bgcolor="#ececec"|'''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 MRI (or CT) beyond 5 years is based on individual patient risk factors|| 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></sup> | |||
== References == | == References == | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Kidney diseases]] | [[Category:Kidney diseases]] | ||
[[Category:Types of cancer]] | [[Category:Types of cancer]] | ||
Revision as of 19:03, 11 January 2014
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Renal cell carcinoma Microchapters |
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Renal cell carcinoma MRI On the Web |
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American Roentgen Ray Society Images of Renal cell carcinoma MRI |
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Risk calculators and risk factors for Renal cell carcinoma MRI |
Similar to CT, an MRI may be used to diagnose and for follow-up of renal cell carcinoma. Due to the use of IV gadolinium in MRI, the risk of nephrogenic systemic fibrosis (NSF) must always be considered. It is a rare condition that often has cutaneous manifestations, but may affect any organ. Risk factors for development of NSF are as follows:
- High dose of gadolinium-based contrast
- Acute and chronic renal failure
- Vascular injury
| Patient Profile | Use of MRI | Evidence Strength |
| Low Risk Patient (pT1, N0, Nx) | Baseline abdominal MRI (or CT) for nephron sparing surgery and CT (or US or MRI) for radical nephrectomy within 3-12 months following renal surgery Additional MRI (or US or CT) 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 MRI (or CT) 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 MRI (or CT) beyond 5 years is based on individual patient risk factors | C |
References
- ↑ 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.