What is the role of CT in the workup of renal transitional cell carcinoma?

Updated: Nov 05, 2019
  • Author: Bagi RP Jana, MD, MBA, MHA, FACP; Chief Editor: E Jason Abel, MD  more...
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Answer

CT scanning is useful in the diagnosis and staging of renal urothelial tumors (see the images below). It can distinguish between radiolucent renal stones and upper urinary tract urothelial tumors, in that stones appear opaque on CT scans (>200 Hounsfield units [HU] for uric acid stones versus 60-80 HU for tumors). [14]

CT scan with contrast, vascular phase. Mass can be CT scan with contrast, vascular phase. Mass can be seen in left renal pelvis (black arrows). Patient underwent nephroureterectomy. Tumor was high-grade urothelial carcinoma invading subepithelial tissue (stage T1) and measuring 7.5 × 3.2 × 3 cm.
CT scan, delayed phase. Enhancing mass can be visu CT scan, delayed phase. Enhancing mass can be visualized in left renal pelvis (white arrows).

CT scanning also can be used for determining the local extent the tumor and the presence of distant metastases, but it is of limited value in predicting the pathologic stage of upper urinary tract urothelial tumors (it is accurate in 43-77% of cases).


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