Simple Cyst–appearing Renal Masses at Unenhanced CT: Can They Be Presumed to Be Benign?

O’Connor, Stephen S.; Silverman, Stuart G.; Ip, Ivan K.; Maehara, Cleo K.; Khorasani, Ramin

doi:10.1148/radiology.13122633

Cited by 14 publications

(16 citation statements)

References 18 publications

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“…However, of the four cancers that were found, none were cystic, and, therefore, these results may not have addressed the likelihood of missing a cystic renal cancer. Thus, a larger study was needed to define better the true risk of ignoring a simple cyst-appearing renal mass (94). Of 15 695 patients examined with unenhanced abdominal CT, no cancers were found among 2669 simple cyst-appearing renal masses, 1159 of which were followed up for a mean of 8 years and a minimum of 5 years (95% confidence interval: 0%, 0.4%) ( Fig 6).…”

Section: Contrast-enhanced Ctmentioning

confidence: 99%

Incompletely Characterized Incidental Renal Masses: Emerging Data Support Conservative Management

Silverman¹,

Israel²,

Trinh³

2015

Radiology

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102

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With imaging, most incidental renal masses can be diagnosed promptly and with confidence as being either benign or malignant. For those that cannot, management recommendations can be devised on the basis of a thorough evaluation of imaging features. However, most renal masses are either too small to characterize completely or are detected initially in imaging examinations that are not designed for full evaluation of them. These masses constitute a group of masses that are considered incompletely characterized. On the basis of current published guidelines, many masses warrant additional imaging. However, while the diagnosis of renal cancer at a curable stage remains the first priority, there is the additional need to reduce unnecessary healthcare costs and radiation exposure. As such, emerging data now support foregoing additional imaging for many incompletely characterized renal masses. These data include the low risk of progression to metastases or death for small renal masses that have undergone active surveillance (including biopsy-proven cancers) and a better understanding of how specific imaging features can be used to diagnose their origins. These developments support (a) avoidance of imaging entirely for those incompletely characterized renal masses that are highly likely to be benign cysts and (b) delay of further imaging of small solid masses in selected patients. Although more evidence-based data are needed and comprehensive management algorithms have yet to be defined, these recommendations are medically appropriate and practical, while limiting the imaging of many incompletely characterized incidental renal masses.

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Section: Contrast-enhanced Ctmentioning

confidence: 99%

Incompletely Characterized Incidental Renal Masses: Emerging Data Support Conservative Management

Silverman¹,

Israel²,

Trinh³

2015

Radiology

Self Cite

102

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“…If the renal mass has a homogenous attenuation of 20 HU or less, and has no other features such as wall thickening, septa, or calcifications, it is almost certainly a benign cyst. [20][21][22] If a renal mass has a homogenous attenuation greater than 70 HU, it is almost certainly a benign proteinaceous cyst. 23 Unenhanced attenuation values between 20 and 70 HU are indeterminate and may represent hemorrhagic or proteinaceous cysts but could also represent neoplasms.…”

Section: Imaging Evaluationmentioning

confidence: 99%

Imaging Management of Incidentally Detected Small Renal Masses

Sahni

Silverman

2014

Semin intervent Radiol

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Both imaging and intervention play an increasingly important role in the management of renal masses in general and renal cancer in particular. Indeed, radiologists are often the first to detect and diagnose renal cancer, and now with the burgeoning role of percutaneous ablation, they are often the treating physicians. Renal mass management begins with imaging, and although most can be diagnosed with a high degree of certainty using imaging, some remain indeterminate and require biopsy or observation, now referred to as active surveillance. Although active surveillance strategies have been employed for indeterminate renal masses that have a reasonable chance of being benign, recent data suggest that some renal cancers can undergo active surveillance safely. This article reviews the current imaging-based diagnostic evaluation of incidentally detected small renal masses, the burgeoning role of percutaneous biopsy, and how both imaging and biopsy are used to help select which patients need treatment and which can undergo active surveillance.

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“…For example, O'Connor et al accumulated a cohort of patients with renal cysts to assess the risk of developing renal cancer. 5 Query-based case retrieval refers to applications that index all the radiologic cases by keywords or concept and systems that support queries on the index for specific cases. For example, a user may request all ACL tears in the past 6 months at a given clinic.…”

Section: Section 1: Natural Language Processingmentioning

confidence: 99%

Big Data Analyses in Health and Opportunities for Research in Radiology

Aphinyanaphongs

2017

Semin Musculoskelet Radiol

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Simple Cyst–appearing Renal Masses at Unenhanced CT: Can They Be Presumed to Be Benign?

Abstract: To determine renal cancer incidence in simple cyst-appearing renal masses detected at unenhanced computed tomography (CT).

Cited by 14 publications

References 18 publications

Incompletely Characterized Incidental Renal Masses: Emerging Data Support Conservative Management

Incompletely Characterized Incidental Renal Masses: Emerging Data Support Conservative Management

Imaging Management of Incidentally Detected Small Renal Masses

Big Data Analyses in Health and Opportunities for Research in Radiology

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