Renal cell carcinoma chest x ray

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Overview

The use of chest x-ray in renal cell carcinoma is mainly to detect pulmonary metastasis.

Chest x ray

The use of chest x-ray in renal cell carcinoma is mainly to detect pulmonary metastasis.

The following guidelines of the American Urological Association in 2013 state the following regarding the use of chest xray in renal cell carcinoma:

Use of Chest Xray in Renal Cell Carcinoma

Patient Profile	Use of Chest-Xray	Evidence Strength
Low Risk Patient (pT1, N0, Nx)	Yearly chest x-ray to assess for pulmonary metastases for 3 years and only as clinicall indicated beyond that time period	C
Moderate to High Risk Patients (pT2-4N0 Nx or any stage N+)	Chest-xray to be performed every 6 months following a baseline CT or MRI (within 3 to 6 months post-surgery) for at least 3 years and annually thereafter to year 5. Imaging, including chest-xray is warranted by clinical symptoms suggestive of recurrence of metastatic spread. Any imaging, including chest x-ray beyond 5 years may be performed at the discretion of the clinician for moderate to high risk patients	C
Active surveillance	Patients with biopsy-proven renal cell carcinoma or tumor with oncocytic features should undergo an annual chest-xray to assess for pulmonary metastases	C
Patients undergoing ablative procedures with biopy-proven low-risk renal cell carcinoma, oncocytoma, tumor with oncocytic features, non-diagnostic biopsy, or no previous biopsy	Annual chest x-ray for 5 years. Imaging beyond 5 years based on individual patient risk factors and determination of treatment success	Expert opinion

^{Adapted from Donat SM et al. Follow-up for clinically localized renal neoplasms: AUA guideline. J Urol. 2013; 190(2):407-16.}