El RENAL score en la estadificación prequirúrgica de tumores renales. Actualización en radiología

Abstract

Renal carcinoma is one of the most common and letal cancers. The widespread use of imaging techniques, particularly ultrasound and multislice computed tomography (MSCT), and its increased sensitivity, has led to a large number of incidental diagnoses. Partial nephrectomy (PN) has increased in recent years. This technique is chosen to remove small renal tumours because it offers better residual renal function.In order to evaluate the possibility of a PN and to estimate the degree of surgical difficulty, Uzzo and Kutikov have developed a scoring system called RENAL score (RS) based on the most relevant anatomical surgical characteristics of solid kidney masses. It evaluates the maximum tumour radius (R), exophytic/endophytic proportion (E), nearness to the collecting system (N), anterior/posterior descriptor (A), and location relative to the polar lines (L). Four of these components add points for the nephrometry calculation, and the result stratifies tumours into low, moderate, and high surgical complexity. Radiologists must understand how to calculate the RS, and should include it in diagnostic reports in order to provide complete anatomical information for the possible surgery.The purpose of this paper is to describe the components of the RS and its calculation using MSCT images.