Development and progression of chronic kidney disease (CKD) in patients with renal cell carcinoma (RCC) after radical nephrectomy remains an extremely pressing contemporary issue. Postoperative changes of the ultrasound resistance index (RI) in the contralateral kidney not affected by the tumor after surgical treatment of RCC, as well as correlations between changes in IR and in glomerular filtration rate (GFR) remain far from being comprehensively investigated. The RI changes in the parenchyma of the intact (unaffected by the tumor) kidney before and after surgical treatment for RCC, and establishing correlations between RI changes and creatinine-dependent GFR remain unexplored issues.
It can be argued that the apparent diffusion coefficient of diffusion-weighted images of MRI can be used as potential imaging marker for the iagnosis of local recurrence of RCC, provided it is localized in the renal parenchyma. However, further investigations with more cases are required.
To summarize, being an attractive research topic, the radiogenomics of PCa currently is not a comprehensively investigated area of oncourology. According to preliminary research findings conducted in this field, the combination of genomics and radiomics (and presumably metabolomics, proteomics, and transcriptomics) as integrative parts of precision medicine in the future has the potential to become the foundation for a personalized approach to the management of PCa. However, there are a number of hindrances to achieving this goal, such as relatively small numbers of patients included in current studies, a lack of available large randomized controlled trials, the need to use complex integrated methods of big data analysis, the comparatively high cost of genomic profiling and imaging methods, and the question of whether, before we include any potential genomic or transcriptomic marker into radiogenomic analysis, it should first be validated in order to prove its separate clinical value. If so, it greatly and significantly shifts the horizon of the actual use of radiogenomics in clinical practice, owing to the need for a huge body of future research.