Kutizov and Uzzo reported the RENAL Nephrotomy score for patients with renal malignancies. The authors are from Fox Chase Cancer Center and Temple University in Philadelphia.
Parameters:
(1) radius (R) - maximum diameter in cm (NOTE: not radius)
(2) exophytic/endophytic properties (E) - in percent
(3) nearness of the tumor to the collecting system or sinus (S) - in mm
(4) anterior or posterior descriptor (A)
(5) location of the tumor relative to the polar lines (L)
Rules for the measuring the exophytic to endophytic distances:
(1) exophytic distance: perpendicular distance from the "normal" renal surface to the most exophytic point in mm
(2) endophytic distance: perpendicular distance from the "normal" renal surface to the most endophytic point in mm
(3) The two distances do not need to be in the same imaging slice.
(4) It appears that (a) the 2 distances are added (b) the exophytic distance is divided by the total and (c) the ratio is reported as a percent.
Polar lines:
(1) Take a cross-sectional image of the kidney in its midline in the coronal plane.
(2) The upper polar line is a horizontal line that runs through the lowest point of renal cortical tissue anterior to the renal pelvis in the superior half of the kidney.
(3) The upper polar line is a horizontal line that runs through the highest point of renal cortical tissue anterior to the renal pelvis in the inferior half of the kidney.
(4) The axial renal midline is a horizontal line midway between the upper and lower polar lines.
|
Parameter |
Finding |
Points |
|
radius |
<= 4 cm |
1 |
|
|
4.1 to 6.9 cm |
2 |
|
|
>= 7 cm |
3 |
|
exophytic to endophytic |
>= 50% |
1 |
|
|
1 to 49% |
2 |
|
|
entirely endophytic (no exophytic component) |
3 |
|
nearness of tumor |
>= 7 mm |
1 |
|
|
4.1 to 6.9 mm |
2 |
|
|
<= 4 mm |
3 |
|
location of the tumor relative to the tumor lines |
entirely above the upper polar line OR entirely below the lower polar line |
1 |
|
|
<= 50% of tumor crosses a polar line |
2 |
|
|
(> 50% of the tumor crosses a polar line) OR (mass crosses the axial midline) OR (mass entirely between the polar lines) |
3 |
total score =
= SUM(points for all 4 scored parameters)
|
Additional Designator |
Finding |
Designator Code |
|
anterior to posterior descriptor |
anterior |
a |
|
|
posterior |
p |
|
|
neither anterior nor posterior |
x |
|
relation to main renal artery or vein |
tumor touches |
h |
|
|
does not touch |
<none> |
Interpretation:
• minimum RENAL score: 4
• maximum RENAL score: 12
• The higher the score the greater the complexity of the tumor.
|
Total Score |
Complexity |
|
4, 5 or 6 |
low |
|
7, 8 or 9 |
moderate |
|
10, 11, or 12 |
high |
Specialty: Hematology Oncology, Surgery, general, Nephrology
ICD-10: ,
