Is dual-phase abdominal CT necessary for the optimal detection of metastases from renal cell carcinoma?

• Published in: Clinical radiology 2011-11, Vol.66 (11), p.1055-1059
• Main Authors: Jain, Y, Liew, S, Taylor, M.B, Bonington, S.C
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Renal Cell - diagnostic imaging; Carcinoma, Renal Cell - secondary; Contrast Media; Female; Humans; Kidney Neoplasms - diagnostic imaging; Kidney Neoplasms - pathology; Kidneys; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - secondary; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - secondary; Radiography, Abdominal; Radiology; Retrospective Studies; Tomography, X-Ray Computed; Tumors of the urinary system
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2011.06.002

Aim To determine whether dual-phase abdominal computed tomography (CT) detected more metastases than portal-phase CT alone in patients with renal cell carcinoma (RCC). Materials and methods Audit committee approval was obtained. A retrospective audit was undertaken in 100 patients who underwent both arterial and portal phase CT. The CT images were independently reviewed by two consultant radiologists. The presence of metastases in the liver, pancreas, and contralateral kidney were recorded for each phase of contrast enhancement. Results Metastases were identified in the liver in 27 patients, pancreas in 12, and contralateral kidney in 23 patients. Nine of the 27 (33%) liver metastases, three of the 12 (25%) pancreatic metastases, and two of the 23 (9%) renal metastases were only detected in the arterial phase, whilst four of the 27 (15%) liver metastases, three of the 12 (25%) pancreatic metastases, and two of the 23 (9%) renal metastases were only detected in the portal phase. Nine patients (9%) had metastases only visualized in the arterial phase, and six (6%) only in the portal phase. Detection of metastases only visible in the arterial phase led to a change of management in two patients (2%). Conclusion The audit results support our current standard of dual-phase abdominal CT for optimal detection of RCC metastases.