Spiral computed tomography in the diagnosis of renal masses

Rankin, Sheila; Webb, Judith A. W.; Reznek, Rodney H.

doi:10.1046/j.1464-410x.2000.00590.x

Cited by 12 publications

(9 citation statements)

References 60 publications

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“…Venous involvement is one of the crucial factors in surgical planning for patients with RCC. CECT is highly accurate in detecting RV and IVC extension [13,14] and its sensitivity and accuracy in this series was 85 and 92.5%, respectively. MRI turned out to be the best noninvasive technique for assessing thrombus extension with a sensitivity of 88, 100 and 80% for RV, IVC and right atrium, respectively [15,16].…”

Section: Discussionmentioning

confidence: 59%

Impact of Imaging and Thrombus Level in Management of Renal Cell Carcinoma Extending to Veins

Gupta

Ansari²,

Khaitan³

et al. 2004

Urol Int

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Objectives: To evaluate the role of newer imaging modalities in the diagnosis and evaluation of management according to extent of renal vein (RV) or inferior vena cava (IVC) thrombi in patients with renal cell carcinoma. Material and Methods: Fifty-nine patients with renal cell carcinoma and tumor thrombus extension into the RV or IVC were studied. Diagnosis was based on contrast-enhanced CT, magnetic resonance imaging or color-Doppler ultrasonography. Surgical treatment was contemplated in 42 suitable patients and complete resection could be done in all but 3 cases. Results: There were 48 males and 11 females with mean age of 51.8 years. Isolated RV involvement was seen in 27 cases whereas IVC extension was present in 32 cases. The thrombus extent was infrahepatic in 62.5% (20/32) patients with IVC extension. With the newer imaging modalities like contrast-enhanced CT, color-Doppler ultrasound and/or magnetic resonance imaging, correct diagnosis of the extent of the thrombus was possible in 95% of the patients. The accuracy of color-Doppler ultrasound was same as magnetic resonance imaging in the evaluation of the extent of the thrombus. In the present series a median follow-up of 4 years revealed a high incidence of local and distant recurrences and decreased survival in patients presenting with advanced disease, who had venous wall invasion. Conclusions: The extent of RV or IVC thrombi can be accurately diagnosed with contrast-enhanced CT scan and in case of doubt color-Doppler ultrasound is a good alternative to magnetic resonance imaging. Management can be planned according to the level of the tumor thrombus. Invasion of the venous wall was found to be a bad prognostic factor affecting survival.

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Section: Discussionmentioning

confidence: 59%

Impact of Imaging and Thrombus Level in Management of Renal Cell Carcinoma Extending to Veins

Gupta

Ansari²,

Khaitan³

et al. 2004

Urol Int

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“…CT represents the gold standard for the diagnosis, staging and surveillance of RCC. Nowadays, the triphasic (unenhanced, arterial and nephrographic phase) multidetector CT with 3D reconstruction provides the surgeon with comprehensive and reliable information for accurate preoperative planning (4, 8).…”

Section: Discussionmentioning

confidence: 99%

Different Presentations of Renal Cell Cancer on Ultrasound and Computerized Tomography

et al. 2014

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Renal cell carcinoma (RCC) is the most common malignant tumor of the kidney. The major goal of imaging techniques is to correctly differentiate between benign and malignant renal lesions. We present the cases of six patients with renal masses that were interpreted completely differently based on ultrasound (US) and computerized tomography (CT) findings.From January 1st, 2008 to March 1st, 2014, 307 patients from our center underwent nephrectomy for RCC. In all patients US and CT were performed before the operation.In six patients, the US indicated a focal, solid renal lesion that was interpreted by CT as a cystic lesion (Bosniak II-III). Because discrepancies were evident, renal biopsies were performed. The biopsies revealed RCC in the six patients, all of whom underwent subsequent nephrectomy. All of the patients were confirmed to have macroscopically solid RCC without any cystic components.In most cases, CT is the most accurate diagnostic technique for the clinical diagnostic classification of renal masses. In cases where US characterizes a renal lesion as solid, despite CT findings of a cystic lesion, kidney biopsies are recommended. The 6 cases reported here support our belief that, in diagnostic processes of RCC, these techniques should be complementary used.

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“…The corticomedullary phase is characterized by a greater degree of cortex enhancement compared to that of the medulla. Previous human studies indicated that parenchymal lesions such as neoplasia and inflammation can be detected more clearly in nephrographic phase imaging than in corticomedullary phase imaging [ 4 7 15 19 24 26 ]. However, when non-enhanced CT or enhanced corticomedullary phase and nephrographic phase CT imaging are applied, renal lesion identification and characterization are improved, and staging of renal cell carcinomas is characterized more accurately than when only corticomedullary phase or nephrographic phase is solely performed [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Optimization of scan delay for multi-phase computed tomography by using bolus tracking in normal canine kidney

et al. 2018

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This study was performed to optimize scan delays for canine kidney by using a bolus-tracking technique. In six beagle dogs, computed tomography (CT) of the kidney was performed three times in each dog with different scan delays after a bolus-tracking trigger of 100 Hounsfield units (HU) of aortic enhancement. Delays were 5, 20, 35, and 50 sec for the first scan, 10, 25, 40, and 55 sec for the second scan, and 15, 30, 45, and 60 sec for the third scan. The renal artery-to-vein contrast difference peaked at 5 sec, and the renal cortex-to-medulla contrast difference peaked at 10 sec. The renal cortex-to-medulla contrast difference approached zero at a scan delay of 30 sec after the bolus trigger. For the injection protocol used in this study, the optimal scan delay times for renal arterial, corticomedullary, and nephrographic phases were 5, 10, and 30 sec after triggering at 100 HU of aortic enhancement using the bolus-tracking technique. The bolus-tracking technique is useful in multi-phase renal CT study as it compensates for different transit times to the kidney among different animals, requires a small dose of contrast media, and does not require additional patient radiation exposure.

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Spiral computed tomography in the diagnosis of renal masses

Cited by 12 publications

References 60 publications

Impact of Imaging and Thrombus Level in Management of Renal Cell Carcinoma Extending to Veins

Impact of Imaging and Thrombus Level in Management of Renal Cell Carcinoma Extending to Veins

Different Presentations of Renal Cell Cancer on Ultrasound and Computerized Tomography

Optimization of scan delay for multi-phase computed tomography by using bolus tracking in normal canine kidney

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