Value of Computerized Tomography and Ultrasonography in the
Preoperative Diagnosis of Renal Cell Carcinoma Extending into the
Inferior Vena Cava

Giuliani, L.; Giberti, Claudio; Martorana, Giuseppe; Isotta, A; Ce, Neumaier

doi:10.1159/000472731

Cited by 13 publications

(6 citation statements)

References 15 publications

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“…Imaging assessment of vascular invasion is a secondary consideration in humans with adrenal masses because this is relatively uncommon. Therefore, in humans, the CT protocol for assessing an adrenal mass typically consists of precontrast, immediate postcontrast, and 10‐min delayed postcontrast images with 3–5 mm collimation 26–33 . However, delayed postcontrast images acquired at least 10 min after injection of contrast medium may be useful to document the presence of contrast enhancing intraluminal tumor.…”

Section: Discussionmentioning

confidence: 99%

Contrast‐enhanced Computed Tomography as a Preoperative Indicator of Vascular Invasion From Adrenal Masses in Dogs

Schultz

Wisner

Johnson

et al. 2009

Vet Radiology Ultrasound

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The purpose of this study was to determine if contrast-enhanced computed tomography (CT) accurately reflected vascular luminal invasion by adrenal masses in dogs. Medical records of 15 dogs with 17 adrenal masses that underwent preoperative CT imaging were reviewed. Presence or absence of vascular invasion was confirmed by surgery or necropsy/histology. Vascular invasion was identified correctly using contrast-enhanced CT in 11/12 dogs. The sensitivity and specificity of contrast-enhanced CT for vascular invasion compared with surgery or necropsy was 92% and 100%, respectively. The positive predictive value and negative predictive value of contrast-enhanced CT was 100% and 90%, respectively. The accuracy was 95%. In one dog, invasion of the phrenicoabdominal vein was not identified on CT images. Six of eight masses with vascular invasion where a histologic diagnosis was obtained were malignant. Four of four pheochromocytomas invaded adjacent vasculature. Contrast-enhanced CT provided accurate preoperative assessment of adrenal masses. Vascular invasion by adrenal masses in this study occurred by way of the lumen of the phrenicoabdominal vein with subsequent intraluminal extension into other veins, rather than by erosion through vessel walls.

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Section: Discussionmentioning

confidence: 99%

Contrast‐enhanced Computed Tomography as a Preoperative Indicator of Vascular Invasion From Adrenal Masses in Dogs

Schultz

Wisner

Johnson

et al. 2009

Vet Radiology Ultrasound

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“…Durch die Akquisition eines primä r dreidimensionalen Datensatzes sind die Mö glichkeiten einer multiplanaren oder 3D-Bildrekonstruktion gegeben [1,13,16,22]. Nonetheless, its influence on survival is rather secondary compared with that of local tumor growth, grading and metastasis.…”

Section: Discussionunclassified

Rationelle Diagnostik und operative Therapie des Nierenzellkarzinoms mit Tumorthrombus in der V. cava

et al. 1997

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Venous involvement in renal cell carcinoma (RCC) represents an advanced state of disease. Nonetheless, its influence on survival is rather secondary compared with that of local tumor growth, grading and metastasis. Since conservative treatment in advanced RCC is mainly ineffective, surgical management offers the most promising approach for potential cure. Only patients without metastasis, however, seem to benefit from an aggressive surgical intervention. The surgical technique itself is determined by the vena caval extent of the tumor thrombus. Preferably, noninvasive imaging techniques should provide information about metastasis and the extent of the tumor thrombus. Diagnostic efforts should be adapted to therapeutic feasibility and prognosis in every individual patient in order to avoid fatiguing and costly over-examination. The standards requested above can be realized by use of modern sonographic and computed-tomographic imaging techniques or by magnetic resonance imaging alone. Thus, nowadays, the essential diagnostics in RCC with vena caval involvement may dispense with angiographic examinations.

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“…1 • 8 • 19 For the determination of the cranial extent of thrombus, sonography is more reliable than CT and venacavography. 19 Nevertheless, since the studies on sonographic evaluation of tumor thrombus in the IVC 1 ·s.-s. 1 :z. 1941 are confined to patients with malignant invasion of the vessel, the specificity of the ultrasonographic diagnosis with respect to the differentiation of tumor and nontumor thrombi is unknown.…”

Section: Discussionmentioning

confidence: 99%

Color Doppler imaging of inferior vena cava: identification of tumor thrombus

Hübsch

Schurawitzki²,

Susani³

et al. 1992

Journal of Ultrasound in Medicine

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Color‐coded Doppler sonography (CCDS) was used for the examination of tumor thrombus (n = 7) and benign thrombosis (n = 6) of the inferior vena cava. Tumor thrombus was due to hepatocellular carcinoma in two cases and to renal cell carcinoma in five cases. Whereas no specific information about the nature of thrombus formation could be gained by gray scale sonography, a typical patchy vascularization pattern was noted within tumor thrombi in six of seven cases using CCDS. This ws due to marked neovascularization within the tumor thrombi, confirmed by histologic examination in all cases. In one patient no vascularization within the tumor thrombus could be observed by CCDS because the thrombus was relatively small. In patients with bland thrombosis, either no vascularization of the thrombus was seen (n = 5) or linear recanalization of the thrombus occurred (n = 1). Therefore, it might be possible to differentiate tumor from nontumor thrombus in the inferior vena cava by using CCDS. Further studies are needed to confirm this preliminary hypothesis.

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Value of Computerized Tomography and Ultrasonography in the Preoperative Diagnosis of Renal Cell Carcinoma Extending into the Inferior Vena Cava

Cited by 13 publications

References 15 publications

Contrast‐enhanced Computed Tomography as a Preoperative Indicator of Vascular Invasion From Adrenal Masses in Dogs

Contrast‐enhanced Computed Tomography as a Preoperative Indicator of Vascular Invasion From Adrenal Masses in Dogs

Rationelle Diagnostik und operative Therapie des Nierenzellkarzinoms mit Tumorthrombus in der V. cava

Color Doppler imaging of inferior vena cava: identification of tumor thrombus

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