A Concise Review of the Multimodality Imaging Features of Renal Cell Carcinoma

Abstract

The evaluation of renal cell carcinoma (RCC) is routinely performed using the multimodality imaging approach, including ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). Ultrasonography is the most frequently used imaging modality for the initial diagnosis of renal masses. The modality of choice for the characterization of the renal mass is multiphasic CT. Recent advances in CT technology have led to its widespread use as a powerful tool for preoperative planning, reducing the need for catheter angiography for the evaluation of vascular invasion. CT is also the standard imaging modality for staging and follow-up. MRI serves as a problem-solving tool in selected cases of undefined renal lesions. Newer MRI techniques, such as arterial spin labeling and diffusion-weighted imaging, have the potential to characterize renal lesions without contrast media, but these techniques warrant further investigation. PET may be a useful tool for evaluating patients with suspected metastatic disease, but it has modest sensitivity in the diagnosis and staging of RCC. The newer radiotracers may increase the accuracy of PET for RCC diagnosis and staging. In summary, the main imaging modality used for the characterization, staging, and surveillance of RCC is multiphasic CT. Other imaging modalities, such as MRI and PET, are used for selected indications.

Impact of Cytoreductive Nephrectomy in the Management of Metastatic Renal Cell Carcinoma: A Multicenter Retrospective Study

“…Approximately 70% of the patients, mainly in Group I, did not undergo pathological diagnosis by biopsy at the initiation of systemic treatment. In addition to the fact that imaging examinations such as CT and MRI could have predicted the histological type [ 45 ], we consider that biopsy was not performed based on the clinical judgment that treatment should be started as soon as possible because of the expected rapid progression of the disease. Empirical therapy might have been administered in many such cases; therefore, the oncological outcomes of Groups I and II could not be accurately evaluated based on the differences in histological types.…”

Crisis Averted: Clinical T1b Renal Mass with Concurrent Arteriovenous Malformation and Renal Vein Thrombus

“…Excretory-phase imaging highlights the tumor's relationship to the collecting system, which will also assist in surgical planning, particularly when attempting a nephron-sparing approach. Addition of three-dimensional volume rendering, multiplanar reformatting, and maximum intensity projection further clarify relationships between hilar structures and tumor and have decreased the need for diagnostic catheter angiography for the sole purpose of preoperative planning [ 16 ]. Catalano et al describe the use of the three above phases with multidetector CT and a high-resolution protocol (one-millimeter-thick images) to correctly detect the presence and size of RCC in all studied patients.…”

Current Imaging Techniques in Renal Cell Carcinoma

“…The renal masses are characterized depending upon their walls and contents on USG and their various enhancement patterns on CT scan. Widely used classification method is Bosniak classification which includes various parameters like, cyst wall, internal septa (thickness and number) and their enhancement patterns, wall or septal calcifications, internal nodules and their enhancement (Table 1) [7]. Considerable proportion of renal masses may display equivocal features on Conventional CT scan and MRI which makes them difficult to be distinguished as benign or malignant [8].…”