Comparative value of ultrasonography, computerized tomography, angiography and excretory urography in the staging of renal cell carcinoma.

From 1982 to 1985, 225 patients with renal cell carcinoma were treated by nephrectomy. To evaluate the diagnostic significance of ultrasonography in predicting tumor stage the results of ultrasonography, computerized tomography, renal angiography and excretory urography were compared to the histopathological findings. Since local tumor extension has a considerable impact on the operation strategy evaluation of the T classification was of particular interest. All 4 diagnostic procedures were performed in 73 of the 225 patients. The T stage was determined correctly by ultrasonography in 77.8 per cent of the patients, while the tumor was not identifiable in only 0.6 per cent. Computerized tomography was almost as reliable as ultrasonography (the T stage was predicted correctly in 72.3 per cent of the examinations). In contrast, the tumor was staged correctly by angiography in only 57.2 per cent of the patients and by excretory urography in only 59.2 per cent. From these results ultrasonography appears to be an effective, noninvasive, inexpensive and safe procedure to evaluate the T stage of renal tumors.