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Published in: World Journal of Urology 12/2018

Open Access 01-12-2018 | Topic Paper

Imaging for the diagnosis and response assessment of renal tumours

Authors: Sabrina H. Rossi, Davide Prezzi, Christian Kelly-Morland, Vicky Goh

Published in: World Journal of Urology | Issue 12/2018

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Abstract

Purpose

Imaging plays a key role throughout the renal cell carcinoma (RCC) patient pathway, from diagnosis and staging of the disease, to the assessment of response to therapy. This review aims to summarise current knowledge with regard to imaging in the RCC patient pathway, highlighting recent advances and challenges.

Methods

A literature review was performed using Medline. Particular focus was paid to RCC imaging in the diagnosis, staging and response assessment following therapy.

Results

Characterisation of small renal masses (SRM) remains a diagnostic conundrum. Contrast-enhanced ultrasound (CEUS) has been increasingly applied in this field, as have emerging technologies such as multiparametric MRI, radiomics and molecular imaging with 99mtechnetium-sestamibi single photon emission computed tomography/CT. CT remains the first-line modality for staging of locoregional and suspected metastatic disease. Although the staging accuracy of CT is good, limitations in determining nodal status persist. Response assessment following ablative therapies remains challenging, as reduction in tumour size may not occur. The pattern of enhancement on CT may be a more reliable indicator of treatment success. CEUS may also have a role in monitoring response following ablation. Response assessments following anti-angiogenic and immunotherapies in advanced RCC is an evolving field, with a number of alternative response criteria being proposed. Tumour response patterns may vary between different immunotherapy agents and tumour types; thus, future response criteria modifications may be inevitable.

Conclusion

The diagnosis and characterisation of SRM and response assessment following targeted therapy for advanced RCC are key challenges which warrant further research.
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Metadata
Title
Imaging for the diagnosis and response assessment of renal tumours
Authors
Sabrina H. Rossi
Davide Prezzi
Christian Kelly-Morland
Vicky Goh
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 12/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-018-2342-3

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