Imaging Protocols for Active Surveillance in Renal Cell Carcinoma

Area of Science:

• Urology
• Oncology
• Radiology

Background:

• Small renal masses (SRMs) are increasingly detected, necessitating clear management guidelines.
• Active surveillance is a viable option for SRMs, particularly in patients with surgical contraindications.

Purpose of the Study:

• To review SRM growth kinetics and imaging modalities.
• To highlight current organizational recommendations for active surveillance of SRMs.
• To discuss oncological outcomes related to surveillance protocols and delayed intervention.

Main Methods:

• Literature review of growth kinetics, imaging, and surveillance guidelines for SRMs.
• Analysis of recent oncological outcomes and progression to intervention.

Main Results:

• Organizational guidelines for SRM surveillance imaging lack specific timing and modality recommendations.
• While criteria for intervention exist, formal guidelines are absent.
• Standardized imaging protocols and prospective trials for SRM surveillance are lacking.

Conclusions:

• Active surveillance is an acceptable strategy for SRMs in high-risk patients.
• There is a need for standardized imaging protocols and further research to optimize SRM surveillance.
• Current guidelines are broad, underscoring the need for more specific recommendations.