Digital subtraction angiography in staging renal cell carcinoma: comparison with computerized tomography and histopathology.

Digital subtraction angiography was compared to computerized tomography and histopathological findings for staging renal cell carcinoma in 24 patients. Injection of contrast material through a 16 gauge angiocatheter into the femoral vein provided digital subtraction cavography, digital subtraction arteriography and excretory urography during 1 investigation. Computerized tomography established the diagnosis in all patients, while digital subtraction angiography showed all angiographic signs of renal cell carcinoma in 14 (58 per cent). T staging was correct on computerized tomography in 18 patients and on digital subtraction angiography in 16. Absence or presence of venous involvement was indicated correctly by computerized tomography in 20 patients and by digital subtraction angiography in 21. In small tumors the combination of ultrasonography, digital subtraction angiography and excretory urography is sufficient for an operation. In all other tumors digital subtraction angiography cannot replace computerized tomography but adds useful information about arterial distribution, possible venous tumor thrombus and the anatomical relationship of vessels.