Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jun 28, 2015; 7(6): 110-127
Published online Jun 28, 2015. doi: 10.4329/wjr.v7.i6.110
Advances of multidetector computed tomography in the characterization and staging of renal cell carcinoma
Athina C Tsili, Maria I Argyropoulou
Athina C Tsili, Maria I Argyropoulou, Department of Radiology, Medical School, University of Ioannina, 45110 Ioannina, Greece
Author contributions: Tsili AC and Argyropoulou MI contributed to this paper.
Conflict-of-interest: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Athina C Tsili, MD, Assistant Professor, Department of Radiology, Medical School, University of Ioannina, Leoforos Panepistimiou, 45110 Ioannina, Greece. a_tsili@yahoo.gr
Telephone: +30-697-6510904 Fax: +30-265-1007862
Received: January 30, 2015
Peer-review started: January 31, 2015
First decision: February 7, 2015
Revised: March 18, 2015
Accepted: April 27, 2015
Article in press: April 29, 2015
Published online: June 28, 2015

Renal cell carcinoma (RCC) accounts for approximately 90%-95% of kidney tumors. With the widespread use of cross-sectional imaging modalities, more than half of RCCs are detected incidentally, often diagnosed at an early stage. This may allow the planning of more conservative treatment strategies. Computed tomography (CT) is considered the examination of choice for the detection and staging of RCC. Multidetector CT (MDCT) with the improvement of spatial resolution and the ability to obtain multiphase imaging, multiplanar and three-dimensional reconstructions in any desired plane brought about further improvement in the evaluation of RCC. Differentiation of RCC from benign renal tumors based on MDCT features is improved. Tumor enhancement characteristics on MDCT have been found closely to correlate with the histologic subtype of RCC, the nuclear grade and the cytogenetic characteristics of clear cell RCC. Important information, including tumor size, localization, and organ involvement, presence and extent of venous thrombus, possible invasion of adjacent organs or lymph nodes, and presence of distant metastases are provided by MDCT examination. The preoperative evaluation of patients with RCC was improved by depicting the presence or absence of renal pseudocapsule and by assessing the possible neoplastic infiltration of the perirenal fat tissue and/or renal sinus fat compartment.

Keywords: Carcinoma, Kidney, Computed tomography, Renal cell carcinoma, Staging, Multidetector computed tomography

Core tip: Multidetector computed tomography (MDCT) remains the most widely available and most effective modality for the detection and staging of renal cell carcinoma (RCC), with a staging accuracy up to 91%. MDCT scanners with the improvement of spatial resolution and the ability to obtain multiplanar and 3D-reconstructions greatly improved the diagnostic performance of CT in characterizing RCC and estimating the extent of the disease. Important information for treatment planning is provided by CT examination, including tumor location and size, renal arterial and venous anatomy and relationship to the pelvicaliceal system.