Staging renal carcinoma. What is sufficient?
We retrospectively reviewed the roentgenographic and pathologic staging of 64 patients with renal cell carcinoma to assess the role of the various staging modalities (ie, angiography, venacavography, bone scanning, ultrasound, computed tomography [CT], and magnetic resonance imaging). Specific attention was directed at detecting vena cava thrombus and metastatic bone disease, factors with a significant impact on the therapeutic approach. The findings support the role of CT as the principle tool for overall staging and the observation that venacavography is not indicated if CT has excluded caval thrombus. Similarly, routine bone scans are not warranted in the absence of an elevated alkaline phosphatase level or bone pain. The key to the more efficient utilization of imaging resources is understanding the capabilities of the technology available.
Benson
M A
MA
Division of Urology, Case Western Reserve University School of Medicine, Cleveland, OH.
Haaga
J R
JR
Resnick
M I
MI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001842:Bone and Bones / Q000000981:diagnostic imaging; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed