Radiography Skeletal Survey There is no relevant literature regarding the use of a radiographic survey of the whole body in the surveillance of small localized renal masses, and this method is not recommended by the guidelines [2,9,11]. Radiography Intravenous Urography There is no relevant literature regarding the use of IV urography in the surveillance of small localized renal masses, and this method is not recommended by the guidelines [2,9,11]. CT Abdomen and Pelvis CT of the abdomen is the most common method by which small renal masses are detected and is also the most commonly used method for surveillance of small localized renal masses. CT of the abdomen performed without Post-treatment Follow-up of Renal Cell Carcinoma Although CT of the abdomen is the most commonly used method for surveillance of small localized renal masses, the benefit of imaging the pelvis during surveillance has not yet been defined and is considered optional in the guidelines [2,9,11]. Data from 2 retrospective studies evaluating RCC staging with CT suggested that imaging of the pelvis had limited benefit for the detection of metastases [33,34]. Because metastatic progression occurs infrequently in patients on active surveillance with T1a renal masses [8,75-78,81-84], CT of the abdomen is preferred over CT of the abdomen and pelvis. CTU There is no relevant literature regarding the use of CTU in the surveillance of small localized renal masses, and this method is not recommended by the guidelines [2,9,11]. CT Chest Chest CT is listed as an alternative to radiography for surveillance of small localized renal masses by the National Comprehensive Cancer Network guidelines [2]. Limited data have demonstrated that CT is more sensitive than radiography for the detection of pulmonary metastases from RCC during staging [27]. However, no comparison between radiography and CT has been reported in the active surveillance setting.
Post Treatment Follow up and Active Surveillance of Renal Cell Carcinoma. Radiography Skeletal Survey There is no relevant literature regarding the use of a radiographic survey of the whole body in the surveillance of small localized renal masses, and this method is not recommended by the guidelines [2,9,11]. Radiography Intravenous Urography There is no relevant literature regarding the use of IV urography in the surveillance of small localized renal masses, and this method is not recommended by the guidelines [2,9,11]. CT Abdomen and Pelvis CT of the abdomen is the most common method by which small renal masses are detected and is also the most commonly used method for surveillance of small localized renal masses. CT of the abdomen performed without Post-treatment Follow-up of Renal Cell Carcinoma Although CT of the abdomen is the most commonly used method for surveillance of small localized renal masses, the benefit of imaging the pelvis during surveillance has not yet been defined and is considered optional in the guidelines [2,9,11]. Data from 2 retrospective studies evaluating RCC staging with CT suggested that imaging of the pelvis had limited benefit for the detection of metastases [33,34]. Because metastatic progression occurs infrequently in patients on active surveillance with T1a renal masses [8,75-78,81-84], CT of the abdomen is preferred over CT of the abdomen and pelvis. CTU There is no relevant literature regarding the use of CTU in the surveillance of small localized renal masses, and this method is not recommended by the guidelines [2,9,11]. CT Chest Chest CT is listed as an alternative to radiography for surveillance of small localized renal masses by the National Comprehensive Cancer Network guidelines [2]. Limited data have demonstrated that CT is more sensitive than radiography for the detection of pulmonary metastases from RCC during staging [27]. However, no comparison between radiography and CT has been reported in the active surveillance setting.