Bone Scan Whole Body The prevalence of osseous metastases has been shown to be low in patients without symptoms (ie, bone pain) or without laboratory abnormalities suggestive of osseous metastases (ie, elevated serum alkaline phosphatase level) [50,51]. Furthermore, the sites commonly involved by osseous metastases, such as the thoracolumbar spine and ribs, are located in areas covered by chest and abdominal imaging. Thus, although Tc-99m bone scanning can be helpful in confirming clinically or radiographically suspected metastatic disease, current guidelines do not support its routine use in surveillance after treatment for localized RCC [2,9,11]. FDG-PET/CT Skull Base to Mid-Thigh There is no relevant literature regarding the use of FDG-PET or PET/CT for the follow-up of patients after localized RCC ablation. At present, the guidelines do not recommend FDG-PET/CT for the surveillance of patients after RCC ablation [2,9,11]. Variant 3: Follow-up for clinically localized renal cell carcinoma; active surveillance. Active surveillance has been increasingly used for the management of small localized renal masses in a selected group of patients with comorbidities or reduced life expectancy in whom the risks associated with surgical excision or ablative therapies surpass the risk of significant disease progression and cancer-specific mortality [2,9,11,75-80]. Post-treatment Follow-up of Renal Cell Carcinoma Current guidelines recommend biopsy of the renal masses to define the surveillance strategy [2,9,11]. Researchers have found that biopsy is being increasingly used for T1a tumors and that patients who undergo biopsy are significantly more likely to be treated with nonsurgical management (36.8%) than those who do not undergo biopsy (11.4%) [85]. Of note, small renal mass growth kinetics can vary greatly, especially during the initial 6 to 12 months of active surveillance [82,84].
Post Treatment Follow up and Active Surveillance of Renal Cell Carcinoma. Bone Scan Whole Body The prevalence of osseous metastases has been shown to be low in patients without symptoms (ie, bone pain) or without laboratory abnormalities suggestive of osseous metastases (ie, elevated serum alkaline phosphatase level) [50,51]. Furthermore, the sites commonly involved by osseous metastases, such as the thoracolumbar spine and ribs, are located in areas covered by chest and abdominal imaging. Thus, although Tc-99m bone scanning can be helpful in confirming clinically or radiographically suspected metastatic disease, current guidelines do not support its routine use in surveillance after treatment for localized RCC [2,9,11]. FDG-PET/CT Skull Base to Mid-Thigh There is no relevant literature regarding the use of FDG-PET or PET/CT for the follow-up of patients after localized RCC ablation. At present, the guidelines do not recommend FDG-PET/CT for the surveillance of patients after RCC ablation [2,9,11]. Variant 3: Follow-up for clinically localized renal cell carcinoma; active surveillance. Active surveillance has been increasingly used for the management of small localized renal masses in a selected group of patients with comorbidities or reduced life expectancy in whom the risks associated with surgical excision or ablative therapies surpass the risk of significant disease progression and cancer-specific mortality [2,9,11,75-80]. Post-treatment Follow-up of Renal Cell Carcinoma Current guidelines recommend biopsy of the renal masses to define the surveillance strategy [2,9,11]. Researchers have found that biopsy is being increasingly used for T1a tumors and that patients who undergo biopsy are significantly more likely to be treated with nonsurgical management (36.8%) than those who do not undergo biopsy (11.4%) [85]. Of note, small renal mass growth kinetics can vary greatly, especially during the initial 6 to 12 months of active surveillance [82,84].