POTENTIAL AND LIMITATIONS OF SPIRAL CT IN THE STAGING OF TRANSITIONAL-CELL CARCINOMA OF THE RENAL PELVIS

Purpose: To assess the value of spiral CT in comparison to conventional CT in the staging of renal pelvic carcinoma. Patients and methods: 35 patients with renal pelvic carcinoma underwent preoperative CT; conventional technique (n = 21) and spiral CT (n = 14) with the reconstruction of thin sections were compared. Results: Non-invasive or minimal invasive tumours (T(A), T1, T2) could not be differentiated with either technique. Small, flat tumours (T(A)) or multicentric tumours may be missed, even if spiral scanning is applied. The separation of local tumour growth from infiltration is significantly improved by spiral CT (12 of 12 patients instead of 18 out of 21 patients with the conventional technique). Tumour size was more accurately measured by spiral CT (correct estimation in 9 of 12 cases compared to 12 of 21) without being significant. Conclusion: Spiral CT with the simultaneous reconstruction of thin sections results in an improved staging of renal pelvic carcinoma. Malignancy, however, cannot be excluded reliably.