Table 2.
Free-text responses from Rounds 1 and 2 of the Delphi process. The text has been lightly edited for clarity and to preserve anonymity
| Round 1 |
| Findings that predict aggressiveness and the presence of bland thrombus would be good to include but may be difficult for some radiologists; hence, I categorized these as optional features. Necrosis should be optional because of the confusion over the exact meaning and lack of pathological correlate for necrosis |
| The presence of calcification should be optional |
| We should consider including polar location, local extent of disease (hilar invasion, collecting system invasion, contacts Gerota’s fascia, invasion through Gerota’s fascia, invasion of adjacent organs), venous invasion, enlarged lymph nodes, and distant metastases |
| Nephrometry score probably should be an optional feature |
| Differentiating urothelial from cortical origin probably should be a core or optional feature |
| Optional features might include vascular anomalies (if any) and the total number of lesions |
| Multiphase MRI or multiphase CT is necessary for subclassifying a renal mass |
| The location in the vertical axis (upper pole/interpolar/lower pole) needs to be a core descriptor |
| We may want to break down fat into macroscopic fat and microscopic fat |
| We include the ‘clear cell RCC likelihood score,’ but I understand this is uncommon at this point |
| Consider differentiating free-floating IVC tumor thrombus from invasive (i.e., into wall) IVC tumor thrombus |
| Length of tumor thrombus should be added |
| Round 2 |
| It is important to report bland thrombus [21] |
| Components of the RENAL Nephrometry score (endophytic/exophytic, nearness to hilum/collecting system, location relative to polar lines, anterior/posterior) [17, 18] is important and should be included in the core template for indeterminate renal masses that may proceed to partial nephrectomy or ablation. These factors are not as important if the size/location of the mass precludes partial nephrectomy |
| Consider including tumor margins: round vs. lobular vs. infiltrative |
| Considering including whether tumor calcifications are present or absent |
| Consider including tumor heterogeneity |