Renal cell carcinoma is a complex group of highly heterogenous renal tumors demonstrating variable biological behavior. Pretreatment imaging of renal cell carcinoma involves accurate assessment of the primary tumor, presence of nodal, and distant metastases. CT and MRI are the key imaging modalities used in the staging of renal cell carcinoma. Important imaging features that impact treatment include tumor extension into renal sinus and perinephric fat, involvement of pelvicalyceal system, infiltration into adrenal gland, involvement of renal vein and inferior vena cava, as well as the presence of metastatic adenopathy and distant metastases. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
Journal of the American College of Radiology : JACR. 2023 May [Epub]
Expert Panel on Urological Imaging , Dhakshinamoorthy Ganeshan, Gaurav Khatri, Norman Ali, Ryan Avery, Melanie P Caserta, Silvia D Chang, Alberto Diaz De Leon, Rajan T Gupta, Andrej Lyshchik, Jeff Michalski, Refky Nicola, Phillip M Pierorazio, Andrei S Purysko, Andrew D Smith, Myles T Taffel, Paul Nikolaidis
The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: ., Panel Chair, UT Southwestern Medical Center, Dallas, Texas., The University of Texas MD Anderson Cancer Center, Houston, Texas, Primary care physician., Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Commission on Nuclear Medicine and Molecular Imaging., Mayo Clinic, Jacksonville, Florida., University of British Columbia, Vancouver, British Columbia, Canada., The University of Texas MD Anderson Cancer Center, Houston, Texas., Duke University Medical Center, Durham, North Carolina., Thomas Jefferson University Hospital, Philadelphia, Pennsylvania., Mallinckrodt Institute of Radiology Washington University School of Medicine, Saint Louis, Missouri; Commission on Radiation Oncology., SUNY Upstate Medical University, Syracuse, New York., Presbyterian Medical Center, University of Pennsylvania, Philadelphia, Pennsylvania; American Urological Association., Cleveland Clinic, Cleveland, Ohio., University of Alabama at Birmingham, Birmingham, Alabama., New York University Langone Medical Center, New York, New York., Specialty Chair, Northwestern University, Chicago, Illinois.