Wilms Tumor-Follow-up Tailored Abdominal CT Examination

Purpose of Review Wilms tumor is the most common renal mass in infancy with peak incidence between 3 and 4 years old. Actual cure rates are around 90%. Current COG recommendations for imaging follow-up after treatment still include abdomino-pelvic CT for the first 18 months in a regimen that totals at least eight follow-up CTs before changing to US examinations. That represents a meaningful radiation exposure in patients who are more susceptible to stochastic effects, due to their low age. Recent Findings Previous recent findings indicate that the pelvic segment can be safely excluded from routine follow-up CT examination, reducing radiation exposure and its risks, especially in regard of gonadal exposure with no loss of relevant oncologic information. Summary There is currently no justification to sustain the recommendation of pelvic CT to follow up all Wilms tumor treated patients. In accordance with as low as reasonably achievable (ALARA) principle, this practice should not be routinely indicated.