Radiography Skeletal Survey There is no relevant literature regarding the use of a radiographic survey of the whole body in the follow-up of patients after surgical excision of RCC, and this method is not included in the guidelines [2,9,11]. Radiography Intravenous Urography There is no relevant literature regarding the use of IV urography in the follow-up of patients after surgical excision of RCC, and this method is not recommended by the guidelines [2,9,11]. CT Abdomen CT of the abdomen is the most commonly used method for surveillance after surgical excision of RCC [29]. CT is a sensitive method for the detection of recurrences in the resection bed and in other more common sites of metastases in the abdomen, such as the contralateral kidney, adrenal glands, liver, and lymph nodes, and in the visualized bones [16,17,20,22,30]. Although several studies have advised against routine imaging of the abdomen after resection of low-risk (T1) tumors because of the low frequency of abdominal recurrences [15,17,21,30], CT of the abdomen is commonly performed in this group, particularly after PN, to serve as a baseline for future comparisons and to evaluate postoperative complications [9]. Although CT of the abdomen performed without and with IV contrast may be considered beneficial in cases in which postoperative changes need to be distinguished from residual or recurrent tumors, in general, surveillance protocols in oncology often use a single-phase examination in the portal- venous phase. Because RCC metastases tend to be hypervascular, some authors have also suggested that arterial phase imaging can be used to complement portal-venous imaging for the detection of RCC metastases to the liver, pancreas, and contralateral kidney.
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 follow-up of patients after surgical excision of RCC, and this method is not included in the guidelines [2,9,11]. Radiography Intravenous Urography There is no relevant literature regarding the use of IV urography in the follow-up of patients after surgical excision of RCC, and this method is not recommended by the guidelines [2,9,11]. CT Abdomen CT of the abdomen is the most commonly used method for surveillance after surgical excision of RCC [29]. CT is a sensitive method for the detection of recurrences in the resection bed and in other more common sites of metastases in the abdomen, such as the contralateral kidney, adrenal glands, liver, and lymph nodes, and in the visualized bones [16,17,20,22,30]. Although several studies have advised against routine imaging of the abdomen after resection of low-risk (T1) tumors because of the low frequency of abdominal recurrences [15,17,21,30], CT of the abdomen is commonly performed in this group, particularly after PN, to serve as a baseline for future comparisons and to evaluate postoperative complications [9]. Although CT of the abdomen performed without and with IV contrast may be considered beneficial in cases in which postoperative changes need to be distinguished from residual or recurrent tumors, in general, surveillance protocols in oncology often use a single-phase examination in the portal- venous phase. Because RCC metastases tend to be hypervascular, some authors have also suggested that arterial phase imaging can be used to complement portal-venous imaging for the detection of RCC metastases to the liver, pancreas, and contralateral kidney.