Comparative Value of Ultrasonography, Computerized Tomography, Angiography and Excretory Urography in the Staging of Renal Cell Carcinoma

Abstract

From 1982 to 1985, 225 patients with renal cell carcinoma were treated by nephrectomy. To evaluate the diagnostic significance of ultrasonography in predicting tumor stage the results of ultrasonography, computerized tomography, renal angiography and excretory urography were compared to the histopathological findings. Since local tumor extension has a considerable impact on the operation strategy evaluation of the T classification was of particular interest. All 4 diagnostic procedures were performed in 73 of the 225 patients. The T stage was determined correctly by ultrasonography in 77.8 per cent of the patients, while the tumor was not identifiable in only 0.6 per cent. Computerized tomography was almost as reliable as ultrasonography (the T stage was predicted correctly in 72.3 per cent of the examinations). In contrast, the tumor was staged correctly by angiography in only 57.2 per cent of the patients and by excretory urography in only 59.2 per cent. From these results ultrasonography appears to be an effective, noninvasive, inexpensive and safe procedure to evaluate the T stage of renal tumors.

Accuracy of Magnetic Resonance Imaging Compared to Computerized Tomography and Renal Selective Angiography in Preoperatively Staging Renal Cell Carcinoma

“…In our study we evaluated the abil ity of MRI, along with CT and renal selective angiogra phy, to predict preoperatively not only the T stage of tumors but the N and V stages as well. Our overall cor rect T staging with CT was 64%, which was lower than the figures between 72.6 and 91 % reported in the inter national literature with 1 patient overstaged more than one stage (pT2 to T4) [4,6,13,18,19]. With MRI our overall success was with 63 % similar to that of CT. How ever, in the T3 stage, MRI had a remarkable sensitivity of 93%.…”

“…The contribution of excretory intravenous urog raphy, ultrasonography (US) and computerized tomog raphy (CT) in staging preoperatively renal cell carci noma is well documented [1][2][3][4][5][6]. Angiography has also been used extensively not only for evaluating venous involvement but for the T staging of tumors as well [5][6][7][8][9][10][11], However, a complete and more precise TNM preop erative staging, including evaluation of the renal vein, requires a combination of the above-mentioned diagnos tic methods [12].…”

“…The contribution of excretory intravenous urog raphy, ultrasonography (US) and computerized tomog raphy (CT) in staging preoperatively renal cell carci noma is well documented [1][2][3][4][5][6]. Angiography has also been used extensively not only for evaluating venous involvement but for the T staging of tumors as well [5][6][7][8][9][10][11], However, a complete and more precise TNM preop erative staging, including evaluation of the renal vein, requires a combination of the above-mentioned diagnos tic methods [12]. The local invasion of the tumor is best assessed with CT and US [4,6,13], For determining vein invasion, angiography is reported to be of advantage, although US and CT have been reported to be of value [5,10,11,[14][15][16], More recently, magnetic resonance imaging (MRI) successfully supplemented the methods of diagnosis and staging of renal masses [17], In our study we evaluate the accuracy of CT, angiography andto our knowledge for the first time -MRI in staging pre operatively renal cell carcinoma, comparing the preoper ative with the operative and histopathological staging.…”

How Accurate Is Diagnostic Imaging in Determination of Size and Multifocality of Renal Cell Carcinoma as a Prerequisite for Nephron-Sparing Surgery?

“…In preoperative diagnosis with reference to staging, CT has a high value. Tammela et al [22] and Frohmüller et al [23] found a correct local tumor staging in 80 and 72.3%, respectively. Also sonography has with 74.5 and 77.8% a high diagnostic ranking concerning tumor staging.…”

Comparison of Ultrasonography, Computerized Tomography and Angiography in Dialysis Patients with Renal Cell Carcinoma

“…According to Taylor et al [7], CT is better than ultrasonography for detecting ACDK in long term dialysis patients, and CT has some margin of superi ority over ultrasonography in detecting small solid renal masses as well. However, Frohmiiller et al [ 15] suggested that ultrasonography appears to be more effective in the evaluation of the T stage of renal tumors compared to CT. No cystic neoplasms were mistaken for benign cysts by ultrasonography [16]. Our results confirm that ultraso nography is an effective method for the detection of renal cancer in patients on dialysis therapy.…”