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 conventiona l CT in the staging of renal pelvic carcinoma. Patients and methods: 3 5 patients with renal pelvic carcinoma underwent preoperative CT; conv entional technique (n = 21) and spiral CT (n = 14) with the reconstruc tion of thin sections were compared. Results: Non-invasive or minimal invasive tumours (T(A), T1, T2) could not be differentiated with eithe r technique. Small, flat tumours (T(A)) or multicentric tumours may be missed, even if spiral scanning is applied. The separation of local t umour growth from infiltration is significantly improved by spiral CT (12 of 12 patients instead of 18 out of 21 patients with the conventio nal technique). Tumour size was more accurately measured by spiral CT (correct estimation in 9 of 12 cases compared to 12 of 21) without bei ng significant. Conclusion: Spiral CT with the simultaneous reconstruc tion of thin sections results in an improved staging of renal pelvic c arcinoma. Malignancy, however, cannot be excluded reliably.