Bildgebende Diagnostik des Nierenzellkarzinoms

There is an increasing tendency of incidental detection of renal cell carcinoma (RCC) in imaging studies performed for other purposes. In most instances multi-detector computerized tomography (MDCT) is the current investigation of choice for confirmation of diagnosis and staging of the primary RCC. Exceptional circumstances where alternative imaging modalities, such as magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA), would be preferred include contrast medium allergy, functional renal impairment and pregnancy. MRI provides excellent soft tissue contrast facilitating evaluation of tumor composition and characterization of masses. Besides identifying these incidental lesions, diagnostic imaging plays an increasingly more prominent clinical role and supports the need for accurate imaging characterization, particularly in the context of newer therapeutic approaches, such as laparoscopic and nephron-sparing approaches. Staging systems are designed to reflect the modes of spread and are used to stratify treatment options and to assess prognosis and survival characteristics.