Published online Jun 28, 2015. doi: 10.4329/wjr.v7.i6.110
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.
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.