Renal Cell Carcinoma Imaging

Objectives: Review the role of imaging in detecting, characterising, and staging renal cell carcinoma (RCC). The imaging features are described and the different diagnostic criteria are analysed based on the methodology used. Methods: The techniques of urography, sonography, computed tomography (CT), and magnetic resonance imaging (MRI) are described and new advances reported synthetically. Results: Currently, urography and angiography are rarely used in urologic practice in developed countries because the cross-imaging techniques have a higher sensitivity and specificity in detecting, characterising, and staging renal tumours. High attenuation values at CT, signal intensity not typical of water or adipose tissue at MRI, and the presence of septations, wall thickening, and nodularity are the main criteria used to define the nature of an expansive renal lesion. The use of ultrasound with and without contrast agents has great promise even if multidetector CT is widely used for the evaluation of the kidneys. Conclusion: Imaging has a major role in detecting and staging of tumoural renal masses. The technical improvements have been associated with a decrease in size of the RCC at diagnosis and in down-staging of the lesions. In many cases the differentiation between a benign and malignant neoplasm is possible.