Name of the Procedure:

Cystic Renal Lesion Evaluation (Bosniak I or II) or Adrenal Lesion Assessment

• Medical Terms: Evaluation of cystic renal lesions (Bosniak Classification I or II) or adrenal lesions ≤ 1.0 cm or > 1.0 cm but ≤ 4.0 cm, classified as likely benign by unenhanced CT or washout protocol CT (HCPCS Code: G9547).

Summary

This procedure involves the evaluation of simple-appearing cystic lesions in the kidneys or small adrenal lesions using a non-contrast or specialized contrast-enhanced CT scan. These lesions are typically considered benign, and the procedure helps confirm their nature.

Purpose

• Medical Conditions Addressed: Monitoring and evaluation of cystic renal or adrenal lesions.
• Goals: To ascertain the benign nature of these lesions and ensure they do not require further invasive treatment.

Indications

• Symptoms/Conditions: Presence of cystic lesions in the kidneys (Bosniak I or II) or small adrenal lesions detected via imaging studies.
• Patient Criteria: Generally appropriate for individuals who have been found to have these types of lesions on initial imaging scans.

Preparation

• Pre-procedure Instructions:
  • Fasting: May be required a few hours before the procedure if contrast material is used.
  • Medication Adjustments: Patients might need to stop certain medications, especially those affecting kidney function.
• Diagnostic Tests: Initial imaging studies to identify the lesions.

Procedure Description

Step-by-Step Explanation:

1. Patient Positioning: The patient lies on the CT scan table.
2. Imaging Process:
   • For unenhanced CT: A series of images are taken without any contrast dye.
   • For washout protocol CT: Initial images are taken, followed by administration of a contrast agent, and then repeat images are captured.
3. Image Analysis: Radiologists will analyze the images to classify the lesion and confirm its benign nature.

Tools/Technology:

• CT Scanner: Used to capture detailed images of the kidneys and adrenal glands.
• Contrast Dye: Used in washout protocol CT to enhance imagery.

Anesthesia/Sedation:

• Generally, no anesthesia or sedation is required.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on whether contrast material is used.

Setting

This procedure is usually performed in a radiology department, either in a hospital or an outpatient imaging center.

Personnel

• Radiologist: Specializes in interpreting medical images.
• Radiologic Technologist: Operates the CT scanner and assists with the procedure.

Risks and Complications

• Common Risks: Exposure to low levels of radiation.
• Rare Risks: Allergic reaction to contrast dye (if used), nephrotoxicity (impact on kidney function) from the dye.

Benefits

• Expected Benefits: Accurate assessment of cystic or adrenal lesions to confirm they are benign.
• Timeline: Results are typically available within a few days, allowing for prompt reassurance or further action if needed.

Recovery

• Post-procedure Care: Generally no special care is needed; patients can resume normal activities immediately.
• Recovery Time: Immediate recovery; no downtime required.
• Follow-up: Based on results, further monitoring or repeat imaging may be recommended.

Alternatives

• Other Options:
  • MRI: Alternative imaging without radiation exposure.
  • Ultrasound: Another non-invasive imaging option, though less detailed for certain lesions.
• Pros and Cons: MRI avoids radiation but is more expensive and may be less available. Ultrasound is readily available but may not provide as detailed an image as CT.

Patient Experience

• During Procedure: Patients remain still during imaging; contrast injections may involve brief discomfort.
• Post-procedure: Some patients might feel minor discomfort from lying still or from the contrast injection. Pain management is typically not necessary.

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