Scottish National Complex Renal Cyst Surveillance Protocol

Area of Science:

• Urology
• Radiology
• Oncology

Background:

• Complex renal cysts categorized as Bosniak IIF require standardized follow-up.
• Existing protocols may lack risk-targeting for optimal patient management.

Purpose of the Study:

• To design and evaluate a risk-targeted imaging protocol for monitoring Bosniak IIF renal cysts.
• To assess the efficacy of the Scottish Protocol in identifying progressive lesions.

Main Methods:

• Prospective data collection from five NHS health boards in Scotland.
• Inclusion of patients with confirmed Bosniak IIF cysts via CT or MRI.
• Review of patient data for progression, interval, treatment, and histology.

Main Results:

• 160 patients with Bosniak IIF cysts were identified; 9.4% (15/160) had confirmed malignancy.
• Progression to treatment occurred in 17 patients, with malignancy most commonly diagnosed within 2 years.
• No metastatic disease was observed during the 4-year follow-up period.

Conclusions:

• The Scottish Complex Renal Cyst Protocol offers a reliable risk-targeted imaging framework.
• The protocol effectively identifies progressive lesions, enabling timely intervention.
• Progression rates align with published data, with most events occurring within 4 years.