Dual-phase helical CT of the kidney: value of the corticomedullary and nephrographic phase for evaluation of renal lesions and preoperative staging of renal cell carcinoma.

Kopka, L.; Fischer, Uwe; Zoeller, G.; Schmidt, Christian; Ringert, R.‐H.; Grabbe, E

doi:10.2214/ajr.169.6.9393168

Cited by 146 publications

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“…In our study, CT and ultrasonography detected 12.5% of multifocality among kidneys with multifocal tumors, preoperatively; this is consistent with published rates of 10-44% [2][3][4][5]19] . However, some researchers have failed to detect multifocality with either ultrasonography or CT [1,6] , while others report 94-95% detection rates using dual-phase helical CT or three-dimensional magnetic resonance imaging [20,21] . In the latter studies, satellite tumors were detected in 1.5-17% of all RCC patients, including unifocals, who underwent RN [20,21] .…”

Section: Discussionmentioning

confidence: 99%

“…However, some researchers have failed to detect multifocality with either ultrasonography or CT [1,6] , while others report 94-95% detection rates using dual-phase helical CT or three-dimensional magnetic resonance imaging [20,21] . In the latter studies, satellite tumors were detected in 1.5-17% of all RCC patients, including unifocals, who underwent RN [20,21] . In our study the rate was calculated as 1.6%.…”

Section: Discussionmentioning

confidence: 99%

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Multifocality Incidence and Accompanying Clinicopathological Factors in Renal Cell Carcinoma

Sargin

Ekmekcioglu²,

Arpalı³

et al. 2009

Urol Int

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Introduction: The incidence of multifocality and associated clinicopathological factors in renal cell carcinoma were evaluated. Materials and Methods: Clinicopathological characteristics were assessed for 122 renal cell carcinoma-pathological specimens from 121 patients. Microscopic and gross tumor pathology, incidence of multifocality as well as association between tumor grade, histological subtype, stage, size and vascular involvement were assessed. Results: Multifocal renal cell carcinoma was diagnosed in 16 of 122 specimens (13.1%). Satellite lesions for 15 of 16 specimens displaying mulifocality had the same histological subtype as their primary tumor. The occult multifocality rate was 11.4%. Tumor grade and stage, but not size or volume, histological subtype, and vascular involvement were significantly related to multifocality. Conclusions: Accurate staging of renal cell carcinoma appears to be essential in determining whether a patient should undergo nephron-sparing surgery or radical nephrectomy. Patients with high stage and grade should receive the highest attention after nephron-sparing surgery. Larger studies are needed to further elucidate the association between clinicopathological factors and multifocality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multifocality Incidence and Accompanying Clinicopathological Factors in Renal Cell Carcinoma

Sargin

Ekmekcioglu²,

Arpalı³

et al. 2009

Urol Int

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“…Detektion und Charakterisierung von Läsionen sind, verglichen mit der arteriellen Phase, in der nephrograpischen Phase am einfachsten, da die Heterogenität der KM-Aufnahme in der arteriellen Phase die Diagnostik erschwert [3]. Dennoch sollten Läsionen unter Einhaltung der Gesamtvorgaben für Dosisexposition in beiden Phasen beurteilt werden, da sowohl die Sensitivität als auch die Spezifität, verglichen mit beiden Phasen allein, steigen [13]. Zeman et al zeigen, dass die exkretorische Phase bessere Testgüteparameter hat als die kortikomedulläre (97 % vs. 77 % Sensitivität, 94 % vs. 85 % Spezifität; [14]).…”

Section: Die Dichtewerte Der Läsion In Der Nativen Ct Spielen Eine Enunclassified

“…Zeman et al zeigen, dass die exkretorische Phase bessere Testgüteparameter hat als die kortikomedulläre (97 % vs. 77 % Sensitivität, 94 % vs. 85 % Spezifität; [14]). Kopka et al zeigen, dass die nephrographische Phase bessere Testgüteparameter aufweist als die kortikomedulläre [13]. Die exkretorische Phase (5-10 min nach KM-Injektion) kann kleine hypervaskularisierte Tumoren nachweisen und die Ausdehnung des Tumors in das Nierenbeckenkelchsystem zeigen [15].…”

Section: Die Dichtewerte Der Läsion In Der Nativen Ct Spielen Eine Enunclassified

Moderne Bildgebung von Nierentumoren – Anwendung in Diagnostik und Therapie

et al. 2016

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This article elucidates the various tools used for the diagnostics and characterization of renal lesions. The advantages and limitations of ultrasound, contrast-enhanced ultrasound (CEUS), computed tomography (CT) and magnetic resonance imaging (MRI) are presented and discussed. In addition, modern imaging features of CT and MRI, such as iodine quantification in CT as well as diffusion-weighted and perfusion imaging in MRI are presented. Lastly, recent developments in standardized reporting of renal tumors regarding the intraoperative surgical risk are presented.

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“…A baseline calculation of eGFR should be done using the following web link for the modification of diet in renal disease or CKD-epi equation (http://www.nephron.com/MDRD_GFR.cgi). Preoperative renal protocol CT imaging must have non contrast views in search of microscopic fat or pseudo enhancement with volume averaging to exclude benign angiomyolipoma and hemorrhagic cyst which could warrant nonoperative management [54]. A contrast enhanced study (MRI, CT or renal perfusion/excretion nuclear scan) is required to document bilateral renal function.…”

Section: Partial Nephrectomy: Indications Preoperative Assessment Anmentioning

confidence: 99%

Open Mini-Flank Partial Nephrectomy: An Essential Contemporary Operation

Russo

2014

Korean J Urol

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Secondary to the widespread use of the modern imaging techniques of computed tomography, magnetic resonance imaging, and ultrasound, 70% of renal tumors today are detected incidentally with a median tumor size of less than 4 cm. Twenty years ago, all renal tumors, regardless of size were treated with radical nephrectomy (RN). Elective partial nephrectomy (PN) has emerged as the treatment of choice for small renal tumors. The basis of this paradigm shift is three major factors: (1) cancer specific survival is equivalent for T1 tumors (7 cm or less) whether treated by PN or RN; (2) approximately 45% of renal tumors have indolent or benign pathology; and (3) PN prevents or delays the onset of chronic kidney disease, a condition associated with increased cardiovascular morbidity and mortality. Although PN can be technically demanding and associated with potential complications of bleeding, infection, and urinary fistula, the patient derived benefits of this operation far outweigh the risks. We have developed a "mini-flank" open surgical approach that is highly effective and, coupled with rapid recovery postoperative care pathways associated with a 2-day length of hospital stay.

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Dual-phase helical CT of the kidney: value of the corticomedullary and nephrographic phase for evaluation of renal lesions and preoperative staging of renal cell carcinoma.

Abstract: OBJECTIVE.Our objective was to evaluate early-phase unenhanced and late-phase con-

Cited by 146 publications

References 0 publications

Multifocality Incidence and Accompanying Clinicopathological Factors in Renal Cell Carcinoma

Multifocality Incidence and Accompanying Clinicopathological Factors in Renal Cell Carcinoma

Moderne Bildgebung von Nierentumoren – Anwendung in Diagnostik und Therapie

Open Mini-Flank Partial Nephrectomy: An Essential Contemporary Operation

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