Imaging of Renal Cancer

Publication date: Available online 10 December 2019Source: Seminars in Ultrasound, CT and MRIAuthor(s): Satheesh Krishna, Ashley Leckie, Ania Kielar, Robert Hartman, Ashish KhandelwalAbstractCystic renal masses are common incidental findings on cross-sectional imaging. Accurate characterisation of cystic renal masses is essential to guide management. Renal mass protocol comprises of a good quality non-contrast, corticomedullary and nephrographic phases with each phase providing complementary information for diagnosis. Attenuation measurements in different phases are central to the ‘golden-rules’ in renal mass imaging in characterisation of cystic renal masses. Newer modalities like dual energy CT, can obviate need for repeat imaging by generation of iodine-overlay image and also help in eliminating artifactual pseudoenhancement which is problematic in small endophytic cysts. Contrast enhanced ultrasound (CEUS) is extremely sensitive in identification of enhancing components in cystic masses especially in the setting of renal failure as the microbubbles are not excreted via the renal route. The Bosniak classification for renal cystic masses has been revised in 2019 to standardise terminology and further improve upon the original version. The current version includes CT and MRI, although CEUS is yet to be included. Image guided biopsy of renal mass helps confirm the diagnosis and also gives information regarding the subtype and grading and is useful in avoiding overtreatmen...
Source: Seminars in Ultrasound, CT and MRI - Category: Radiology Source Type: research