Scientific Status Quo of Small Renal Lesions: Diagnostic Assessment and Radiomics.
Piero TrovatoIgino SimonettiAlessio MorroneRoberta FuscoSergio Venanzio SetolaGiuliana GiacobbeMaria Chiara BruneseAnnarita PecchiSonia TriggianiGiuseppe PellegrinoGiuseppe PetraliaGiacomo SicaAntonella PetrilloVincenza GranataPublished in: Journal of clinical medicine (2024)
Background: Small renal masses (SRMs) are defined as contrast-enhanced renal lesions less than or equal to 4 cm in maximal diameter, which can be compatible with stage T1a renal cell carcinomas (RCCs). Currently, 50-61% of all renal tumors are found incidentally. Methods : The characteristics of the lesion influence the choice of the type of management, which include several methods SRM of management, including nephrectomy, partial nephrectomy, ablation, observation, and also stereotactic body radiotherapy. Typical imaging methods available for differentiating benign from malignant renal lesions include ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), and magnetic resonance imaging (MRI). Results: Although ultrasound is the first imaging technique used to detect small renal lesions, it has several limitations. CT is the main and most widely used imaging technique for SRM characterization. The main advantages of MRI compared to CT are the better contrast resolution and tissue characterization, the use of functional imaging sequences, the possibility of performing the examination in patients allergic to iodine-containing contrast medium, and the absence of exposure to ionizing radiation. For a correct evaluation during imaging follow-up, it is necessary to use a reliable method for the assessment of renal lesions, represented by the Bosniak classification system. This classification was initially developed based on contrast-enhanced CT imaging findings, and the 2019 revision proposed the inclusion of MRI features; however, the latest classification has not yet received widespread validation. Conclusions : The use of radiomics in the evaluation of renal masses is an emerging and increasingly central field with several applications such as characterizing renal masses, distinguishing RCC subtypes, monitoring response to targeted therapeutic agents, and prognosis in a metastatic context.
Keyphrases
- contrast enhanced
- magnetic resonance imaging
- computed tomography
- diffusion weighted
- magnetic resonance
- diffusion weighted imaging
- dual energy
- high resolution
- contrast enhanced ultrasound
- positron emission tomography
- squamous cell carcinoma
- deep learning
- single cell
- chronic kidney disease
- stem cells
- blood pressure
- end stage renal disease
- mesenchymal stem cells
- drug delivery
- ultrasound guided
- newly diagnosed
- prognostic factors
- mass spectrometry
- small cell lung cancer
- single molecule
- high intensity
- heart rate
- radiation therapy
- decision making
- fluorescence imaging
- robot assisted
- optical coherence tomography
- resistance training