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[Diagnostic imaging of renal tumors of small dimensions]
L Dalla Palma1, R Pozzi-Mucelli, S Magnaldi
1Istituto di Radiologia Università Trieste.
Abstract:
The incidence of small renal tumors (less than cm 3) has increased in the past few years. Reasons for the increased number of reports are related to the contribution of Sonography and Computed Tomography--which enable a greater number of kidneys to be examined and allow a more detailed study of renal parenchyma. In order to assess the diagnostic value and role of the various imaging techniques in this pathology, the authors reviewed all renal tumors observed between 1982 and 1987. Nineteen cases presented with the characteristics of small renal tumors with "solid" findings on both US and CT. Sixteen cases were histologically proven (15 adenocarcinomas, 1 oncocytoma). Three recent, unoperated, cases are included since their features are the same as in the other cases. Metastases and other kinds of tumors (i.e. angiomyolipomas) are not included in this series. Ivp was performed in 14/19 cases; US and CT were always performed. CT proved to be the most sensitive technique, being positive in all cases. Ivp was positive in 9/14 cases (64%) and US in 14/19 (73%). A significant increase in the number of small renal tumors detected was observed, mainly in 1985-1987. This increase is correlated with the increase in the total number of abdominal examinations which US and CT have made possible. Most patients were asymptomatic; in fact, 15/19 cases were incidentally discovered with US and CT of the upper abdomen. US and CT appear to give a substantial contribution to an early diagnosis of small renal tumors, which may have a significant impact on both surgery and prognosis.
Insights
The incidence of small renal tumors has increased due to advances in imaging like ultrasound (US) and computed tomography (CT). These techniques significantly aid in early diagnosis, improving patient outcomes.
Area of Science:
- Radiology
- Oncology
- Urology
Background:
- The incidence of small renal tumors (<3 cm) has risen, largely due to improved imaging technologies.
- Sonography (US) and Computed Tomography (CT) allow for more detailed examination of renal parenchyma, increasing detection rates.
Purpose of the Study:
- To evaluate the diagnostic value and role of various imaging techniques in detecting small renal tumors.
- To assess the impact of US and CT on the early diagnosis of these tumors.
Main Methods:
- Retrospective review of 19 cases of small renal tumors with solid findings on US and CT between 1982 and 1987.
- Histological confirmation in 16 cases (15 adenocarcinomas, 1 oncocytoma).
- Comparison of diagnostic sensitivity of Intravenous Pyelography (IVP), US, and CT.
Main Results:
- Computed Tomography (CT) demonstrated the highest sensitivity, detecting all cases.
- Ultrasound (US) detected 73% of cases, while IVP detected 64%.
- A significant increase in small renal tumor detection was observed, correlating with increased abdominal imaging (US and CT). Most tumors were incidentally discovered in asymptomatic patients.
Conclusions:
- US and CT are crucial for the early diagnosis of small renal tumors.
- Early detection via US and CT can positively impact surgical management and patient prognosis.
- The increased use of abdominal imaging has led to a rise in incidentally discovered small renal tumors.