Abstract
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.
Keywords
renal mass - renal cell carcinoma - imaging - biopsy - surveillance
