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The Role of Imaging in the Active Surveillance of Small Renal Masses

  • New Imaging Techniques (A Atala and A Rastinehad, Section Editors)
  • Published:
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Abstract

Up to 66 % of renal cell carcinomas are detected as small renal masses before the presence of clinical symptoms. Small renal mass treatment has evolved from the exclusive use of radical nephrectomy to the use of nephron sparing procedures where possible. An increase in elderly and comorbid patients, together with the notion that just 20 % of small renal masses show high malignant potential, has prompted interest in active surveillance as a treatment option. Modern imaging techniques provide objective follow-up parameters, namely size, invasion of collecting system or perirenal fat and enhancement patterns, with minimal complication risks or patient discomfort. This review evaluates recent developments in the field of active surveillance for small renal masses. Special focus is placed on the role of imaging in the primary decision making and subsequent follow-up during active surveillance.

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Abbreviations

ACT:

11C-acetate

AKI:

Acute kidney injury

AML:

Angiomyolipoma

AS:

Active surveillance

AUA:

American Urological Association

CEUS:

Contrast enhanced ultrasound

CKD:

Chronic kidney disease

CT:

Computed tomography

ccRCC:

Clear cell renal cell carcinoma

EAU:

European Association of Urology

FDG:

18F-fluorodeoxyglucose

HU:

Houndsfields units

MRI:

Magnetic resonance imaging

NSF:

Nephrogenic systemic fibrosis

PET:

Positron emission tomography

RCC:

Renal cell carcinoma

RFA:

Radiofrequency ablation

SRM:

Small renal mass

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Conflict of Interest

Dr. Peter G.K. Wagstaff, Dr. Patricia J. Zondervan, Dr. Jean J.M.C.H. de la Rosette, and Dr. M. Pilar Laguna each declare no potential conflicts of interest relevant to this article.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Urology, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands

    P. G. K. Wagstaff, P. J. Zondervan, J. J. M. C. H. de la Rosette & M. P. Laguna

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  1. P. G. K. Wagstaff
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  2. P. J. Zondervan
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  3. J. J. M. C. H. de la Rosette
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  4. M. P. Laguna
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Correspondence to M. P. Laguna.

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This article is part of the Topical Collection on New Imaging Techniques

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Wagstaff, P.G.K., Zondervan, P.J., de la Rosette, J.J.M.C.H. et al. The Role of Imaging in the Active Surveillance of Small Renal Masses. Curr Urol Rep 15, 386 (2014). https://doi.org/10.1007/s11934-013-0386-x

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