How I do it: evaluating renal masses.

@article{Israel2005HowID,
  title={How I do it: evaluating renal masses.},
  author={Gary M. Israel and Morton A. Bosniak},
  journal={Radiology},
  year={2005},
  volume={236 2},
  pages={
          441-50
        }
}
With modern computed tomography (CT) and magnetic resonance (MR) imaging equipment, the diagnosis of most renal masses is usually straightforward and accurate. The major question to be answered is whether the mass represents a surgical or nonsurgical lesion or, in some cases, if follow-up studies are necessary. This evaluation usually can be accomplished if a high-quality examination is performed, if the clinical history of the patient is kept in mind, if conditions that mimic a renal neoplasm… 
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References

SHOWING 1-10 OF 56 REFERENCES
The current radiological approach to renal cysts.
TLDR
It is imperative that imaging studies be performed with great care, diagnoses be based on rigid criteria, and that more experience with difficult lesions be gained so that the proper approach to treatment will be determined.
Calcification in cystic renal masses: is it important in diagnosis?
TLDR
Calcification in a cystic renal mass is not as important in diagnosis as is the presence of associated enhancing soft-tissue elements, which should enable a reasonable approach to the management of calcium-containing renal cystic lesions.
Renal masses: assessment of corticomedullary-phase and nephrographic-phase CT scans.
TLDR
CT scans obtained only during the CMP of contrast enhancement fail to depict many renal masses that are easily seen on NP images.
Angiomyolipoma (hamartoma) of the kidney: A preoperative diagnosis is possible in virtually every case
TLDR
The clinical, sonographic, computed tomographic, and angiographic findings in 28 patients with this lesion are reviewed and the detection of fat in the renal tumor by CT is diagnostic.
The current role of percutaneous biopsy in the evaluation of renal masses.
TLDR
The indications, techniques, complications, sensitivity, and accuracy of CT and ultrasound-guided biopsy of renal masses, indicated to differentiate between a primary renal cell carcinoma and metastatic disease in patients with a known extrarenal primary are reviewed.
Renal lymphoma: CT patterns with emphasis on helical CT.
  • B. Urban, E. Fishman
  • Medicine
    Radiographics : a review publication of the Radiological Society of North America, Inc
  • 2000
TLDR
Computed tomography (particularly helical CT) is useful in the evaluation of patients with suspected renal lymph cancer, and familiarity with the spectrum of findings in renal lymphoma is important for accurate diagnosis.
Evaluation of patients referred for percutaneous ablation of renal tumors: importance of a preprocedural diagnosis.
TLDR
A substantial percentage of patients referred for percutaneous ablation of renal tumors had benign masses, suggesting CT or MRI alone cannot be used to diagnose a benign entity, and patients should undergo a biopsy before the treatment session.
CT diagnosis of renal angiomyolipoma: the importance of detecting small amounts of fat.
TLDR
Detecting the existence of fat in a renal lesion will establish the diagnosis of angiomyolipoma and is the only radiologic finding that can differentiate it from renal cell carcinoma, so unnecessary surgery will be avoided in patients in which only minimal amounts of fat were evident on CT.
Interobserver variability in determining enhancement of renal masses on helical CT.
TLDR
For most renal lesions, the observers agreed on whether enhancement was present or absent, and the results of region-of-interest measurements suggest the possibility of disagreement among multiple observers.
Incidence of malignancy in complex cystic renal masses (Bosniak category III): should imaging-guided biopsy precede surgery?
TLDR
Renal biopsy and radiologic follow-up were useful in identifying nonmalignant lesions in complex cystic renal masses and avoided unnecessary surgery in 39% of patients.
...
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