In Reply: We agree with Drs Perdeaux and Solly that renal tract visualization is the most important work-up in cases of Birt-Hogg-Dubé syndrome. In our article, we advocated for ultrasound scanning as an acceptable first-line modality for screening purposes, but declared that, if in doubt or when available, MRI can be used. This has the advantage of superior visualization to identify early or small lesions (without any potential radiation risks that come from computed tomography), especially if the patient is to receive repeated scans.
Felton SJ, Madan V. Birt-Hogg-Dubé Syndrome—Reply. JAMA. 2013;309(14):1460–1461. doi:10.1001/jama.2013.2255
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