MRI Abdomen and Pelvis MRI of the abdomen without and with IV contrast is considered in all major guidelines as an adequate method for surveillance of the abdomen after surgical excision of RCC [2,9,11]. MRI has a high soft-tissue contrast resolution and is an accurate method for detecting metastases in the common sites of RCC recurrences (ie, liver, adrenal glands, lymph nodes, contralateral kidney, and bones) [38]. MRI can also assist in the distinction between residual/recurrent disease and postoperative changes after PN [39]. For patients in whom contrast is contraindicated (eg, previous anaphylactic reaction), MRI of the abdomen without IV contrast may be considered appropriate. Although MRI of the abdomen with IV contrast is considered in all major guidelines as an adequate method for surveillance of the abdomen after surgical excision of RCC, imaging the pelvis during surveillance after RCC treatment is considered optional in the guidelines [2,9,11]. There is no relevant literature regarding the use of MRI of the pelvis in the follow-up of patients after surgical excision of RCC, although data from 2 retrospective studies suggested that imaging of the pelvis with CT had minimal benefit for the detection of metastases in patients after RN or PN for RCC [25,32-34]. Therefore, MRI of the abdomen alone may be preferred over MRI of the abdomen and pelvis in this setting. MRU There is no relevant literature suggesting that MRU offers any additional benefit over conventional MRI of the abdomen in the surveillance of patients after treatment of localized RCC, and this method is not included in the guidelines [2,9,11].
Post Treatment Follow up and Active Surveillance of Renal Cell Carcinoma. MRI Abdomen and Pelvis MRI of the abdomen without and with IV contrast is considered in all major guidelines as an adequate method for surveillance of the abdomen after surgical excision of RCC [2,9,11]. MRI has a high soft-tissue contrast resolution and is an accurate method for detecting metastases in the common sites of RCC recurrences (ie, liver, adrenal glands, lymph nodes, contralateral kidney, and bones) [38]. MRI can also assist in the distinction between residual/recurrent disease and postoperative changes after PN [39]. For patients in whom contrast is contraindicated (eg, previous anaphylactic reaction), MRI of the abdomen without IV contrast may be considered appropriate. Although MRI of the abdomen with IV contrast is considered in all major guidelines as an adequate method for surveillance of the abdomen after surgical excision of RCC, imaging the pelvis during surveillance after RCC treatment is considered optional in the guidelines [2,9,11]. There is no relevant literature regarding the use of MRI of the pelvis in the follow-up of patients after surgical excision of RCC, although data from 2 retrospective studies suggested that imaging of the pelvis with CT had minimal benefit for the detection of metastases in patients after RN or PN for RCC [25,32-34]. Therefore, MRI of the abdomen alone may be preferred over MRI of the abdomen and pelvis in this setting. MRU There is no relevant literature suggesting that MRU offers any additional benefit over conventional MRI of the abdomen in the surveillance of patients after treatment of localized RCC, and this method is not included in the guidelines [2,9,11].