Image data sets generated from subtraction of the precontrast from the postcontrast images can assist with evaluation of residual or recurrent tumor enhancement, especially during the first year of follow-up, because of the high signal intensity background of the ablated tumor on T1-weighted images [72]. However, as with CT, persistent tumor enhancement is common after successful ablation, particularly in patients with clear-cell RCC [73], and this enhancement can last for days to months after treatment [72-74]. For patients in whom contrast is contraindicated (eg, previous anaphylactic reaction), MRI of the abdomen without IV contrast may be considered appropriate. MRI Abdomen and Pelvis MRI of the abdomen is commonly used for follow-up after ablation of localized RCC [29]. MRI should be performed without and with IV contrast to assess tumor enhancement. Image data sets generated from subtraction of the precontrast from the postcontrast images can assist with evaluation of residual or recurrent tumor enhancement, especially during the first year of follow-up, because of the high signal intensity background of the ablated tumor on T1-weighted images [72]. However, as with CT, persistent tumor enhancement is common after successful ablation, particularly in patients with clear-cell RCC [73], and this enhancement can last for days to months after treatment [72-74]. For patients in whom contrast is contraindicated (eg, previous anaphylactic reactions), MRI of the abdomen without IV contrast may be considered appropriate. There is no relevant literature regarding the use of MRI of the pelvis in the follow-up of patients after RCC ablation. Imaging of the pelvis with CT has been found to provide minimal benefit for the detection of metastases in the initial staging and after RN or PN for RCC [25,32-34] and is considered optional in the surveillance guidelines [2,9,11].
Post Treatment Follow up and Active Surveillance of Renal Cell Carcinoma. Image data sets generated from subtraction of the precontrast from the postcontrast images can assist with evaluation of residual or recurrent tumor enhancement, especially during the first year of follow-up, because of the high signal intensity background of the ablated tumor on T1-weighted images [72]. However, as with CT, persistent tumor enhancement is common after successful ablation, particularly in patients with clear-cell RCC [73], and this enhancement can last for days to months after treatment [72-74]. For patients in whom contrast is contraindicated (eg, previous anaphylactic reaction), MRI of the abdomen without IV contrast may be considered appropriate. MRI Abdomen and Pelvis MRI of the abdomen is commonly used for follow-up after ablation of localized RCC [29]. MRI should be performed without and with IV contrast to assess tumor enhancement. Image data sets generated from subtraction of the precontrast from the postcontrast images can assist with evaluation of residual or recurrent tumor enhancement, especially during the first year of follow-up, because of the high signal intensity background of the ablated tumor on T1-weighted images [72]. However, as with CT, persistent tumor enhancement is common after successful ablation, particularly in patients with clear-cell RCC [73], and this enhancement can last for days to months after treatment [72-74]. For patients in whom contrast is contraindicated (eg, previous anaphylactic reactions), MRI of the abdomen without IV contrast may be considered appropriate. There is no relevant literature regarding the use of MRI of the pelvis in the follow-up of patients after RCC ablation. Imaging of the pelvis with CT has been found to provide minimal benefit for the detection of metastases in the initial staging and after RN or PN for RCC [25,32-34] and is considered optional in the surveillance guidelines [2,9,11].