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Optimal follow-up intervals in active surveillance of renal masses in patients with von Hippel-Lindau disease

  • Oncology
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To estimate an optimal follow-up (FU) interval for von Hippel-Lindau (VHL) patients with renal masses (RMs) by determining tumour growth rates from growth curves.

Methods

Thirty lesions (47.6 %) were classified as solid tumours (STs) and 33 (52.4 %) as complex cysts (CCs). Variations in lesion volume over time were analyzed. For 53 lesions, we calculated the growth rate during the period when the volume of the lesion changed most rapidly, and called this the fast growth rate (FGR).

Results

The STs initially grew fast, followed by a period of slower growth. The CCs varied in volume over time, associated with variable amounts of their fluid component. The FGR correlated better with the latest volume for STs (r = 0.905) than for CCs (r = 0.780). An optimal FU interval between 3 and 12 months was derived by combining the FGR calculated from the curve with the latest volume measured.

Conclusions

Analyzing growth curves and related kinetic parameters for RMs in VHL patients could be useful with a view to optimizing the subsequent FU interval and improving the active surveillance program.

Key Points

• Measuring volume changes over time enables tumour growth curves to be charted.

• Renal solid tumours increase in volume with a typical sigmoidal curve.

• Complex cysts may increase and decrease in volume spontaneously over time.

• The fast growth rate of solid tumours correlates with their latest volume.

• The fast growth rate can orient the scheduling of subsequent follow-ups.

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Abbreviations

CCs:

Complex cysts

DT:

Doubling time

FGR:

Fast growth rate

FU:

Follow-up

GR:

Growth rate

MRI:

Magnetic resonance imaging

RCC:

Renal cell carcinoma

RMs:

Renal masses

STs:

Solid tumours

VHL:

Von Hippel-Lindau

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Acknowledgments

The authors would like to thank Andrea Azzalini for help in preparing the illustrations. The scientific guarantor of this publication is Gisella Gennaro. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was not required for this study because it retrospectively evaluated images already acquired for the standard patient FU, with no effect on the patients themselves. The study subjects have never been previously reported. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Radiology Unit, Veneto Institute of Oncology IOV—IRCCS, via Gattamelata, 64, 35128, Padua, Italy

    Fabio Pomerri, Chiara Dal Bosco, Pier Carlo Muzzio & Gisella Gennaro

  2. Familial Cancer Clinics and Oncoendocrinology Unit, Veneto Institute of Oncology IOV—IRCCS, Padua, Italy

    Giuseppe Opocher

  3. Department of Medicine, University of Padua, Padua, Italy

    Fabio Pomerri & Giuseppe Opocher

Authors
  1. Fabio Pomerri
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  2. Giuseppe Opocher
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  3. Chiara Dal Bosco
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  4. Pier Carlo Muzzio
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  5. Gisella Gennaro
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Correspondence to Gisella Gennaro.

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Pomerri, F., Opocher, G., Bosco, C.D. et al. Optimal follow-up intervals in active surveillance of renal masses in patients with von Hippel-Lindau disease. Eur Radiol 25, 2025–2032 (2015). https://doi.org/10.1007/s00330-015-3591-9

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  • DOI: https://doi.org/10.1007/s00330-015-3591-9

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