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Management of Incidental Renal Mass on CT
Ghaneh Fananapazir, MD, FSAR, FSRU, FSABI
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KEY FACTS

  • Terminology

    • Clinical Implications

      TERMINOLOGY

      • Abbreviations

        • Too small to characterize (TSTC)
        • Angiomyolipoma (AML)
        • Renal cell carcinoma (RCC)
        • Contrast-enhanced ultrasound (CEUS)
      • Definitions

        • Incidental renal mass: Incidentally detected mass on imaging for indications other than assessment of urinary tract disease
      • ACR Recommendations, 2017

        • Recommendations based on published evidence and expert opinion
        • Algorithm categorizes lesions on basis of imaging findings
        • Applicable for adults (18 years and older)
        • Not applicable
          • Those with genetic syndromes that are predisposed to renal neoplasms
          • Those with primary cancer that may predispose to renal metastatic disease (lung cancer, melanoma, lymphoma)
      • ACR Appropriateness Criteria for Indeterminate Renal Mass, 2020

        • Recommendations based on published evidence and expert opinion
        • Indeterminate renal mass recommendations
        • CEUS is now included with dedicated CT and MR in work-up of incidental indeterminate renal lesions

      CLINICAL IMPLICATIONS

      • Clinical Importance

        • Clinical Considerations

          • Characterizing Incidental Renal Mass on CT

            • Management of Incidental Renal Mass on CT

              Selected References

              1. Expert Panel on Urologic Imaging. et al: ACR Appropriateness Criteria® Indeterminate Renal Mass. J Am Coll Radiol. 17(11S):S415-28, 2020
              2. Herts BR et al: Management of the incidental renal mass on CT: a white paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 15(2):264-73, 2018
              Related Anatomy
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              References
              Tables

              Tables

              KEY FACTS

              • Terminology

                • Clinical Implications

                  TERMINOLOGY

                  • Abbreviations

                    • Too small to characterize (TSTC)
                    • Angiomyolipoma (AML)
                    • Renal cell carcinoma (RCC)
                    • Contrast-enhanced ultrasound (CEUS)
                  • Definitions

                    • Incidental renal mass: Incidentally detected mass on imaging for indications other than assessment of urinary tract disease
                  • ACR Recommendations, 2017

                    • Recommendations based on published evidence and expert opinion
                    • Algorithm categorizes lesions on basis of imaging findings
                    • Applicable for adults (18 years and older)
                    • Not applicable
                      • Those with genetic syndromes that are predisposed to renal neoplasms
                      • Those with primary cancer that may predispose to renal metastatic disease (lung cancer, melanoma, lymphoma)
                  • ACR Appropriateness Criteria for Indeterminate Renal Mass, 2020

                    • Recommendations based on published evidence and expert opinion
                    • Indeterminate renal mass recommendations
                    • CEUS is now included with dedicated CT and MR in work-up of incidental indeterminate renal lesions

                  CLINICAL IMPLICATIONS

                  • Clinical Importance

                    • Clinical Considerations

                      • Characterizing Incidental Renal Mass on CT

                        • Management of Incidental Renal Mass on CT

                          Selected References

                          1. Expert Panel on Urologic Imaging. et al: ACR Appropriateness Criteria® Indeterminate Renal Mass. J Am Coll Radiol. 17(11S):S415-28, 2020
                          2. Herts BR et al: Management of the incidental renal mass on CT: a white paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 15(2):264-73, 2018