A PLACE THEY CALL AMERICA WM PANZARELLA IMAGE SERIAL
Active surveillance is defined as the initial management including the monitoring of renal tumor size by serial imaging with delayed treatment in case of progression and is now considered as an option in the treatment of localized renal tumors (Fig. An important proportion of SRMs are diagnosed in older patients or patients with multiple comorbidities, in whom surgery might outweigh the potential clinical benefits of active surveillance (AS). Optimal management of SRMs should balance the need for treatment, as around 25% of all small masses are benign lesions, with the goal of preserving renal function as far as possible and avoiding the risk of overtreatment.
Adequate clinical management of SRMs is important despite their slow growth and rare metastatic potential. SRMs are defined as incidentally image-detected, contrast-enhancing renal tumors less than or equal to 4 cm in diameter which are usually consistent with stage T1a renal cell carcinoma. Over the last 20 years, the incidence of renal cell carcinoma (RCC) has increased globally due to advances in cross-sectional imaging of small renal masses (SRMs). In this work, the authors aimed to provide a thorough review of imaging in the context of active surveillance of renal masses. The purpose of this article is to review the indications and management of AS in SRMs, especially focused on specific scenarios, such as complex renal cysts and multifocal renal tumors (sporadic or hereditary). Indeed, radiologists must determine which patients with SRMs or complex renal cysts can be included in AS, establish the follow-up radiological test algorithm to be used in different scenarios, perform measurements in follow-up tests, and decide when AS should be discontinued. Radiologists play a key role in the AS of both unifocal and multifocal (sporadic or associated with genetic syndromes) SRMs as well as in the follow-up of complex renal cysts using the Bosniak cyst classification system. Radiologists have a key position in AS management of SRMs even unifocal and multifocal (sporadic or associated with genetic syndromes) and also in the follow-up of complex renal cysts by Bosniak cyst classification system.
Delayed intervention of SRMs by closed and routine imaging follow-up known as active surveillance (AS) is now an option according to urological guidelines. Enhanced renal masses less than 4 cm in size are known as small renal masses (SRMs), and their growth rate (GR) and the possibility of developing metastasis are extremely low. Most renal masses incidentally detected by cross-sectional images are benign, being mainly cysts, and if they are malignant, they are indolent in nature with limited metastatic potential.
0 kommentar(er)
