Comparison of computed tomography and angiography in the evaluation of renal cell carcinoma.

CT scans and angiograms in patients with renal cell carcinoma were reviewed to determine their accuracy in predicting perinephric, retroperitoneal lymph node, renal vein and inferior vena caval involvement by tumor. Results were correlated with pathologic diagnoses from open biopsy or nephrectomy specimens in 62 cases. Computed tomography was more accurate and sensitive than angiography in detecting perinephric extension, more sensitive in assessing lymph node involvement, and equally accurate in detecting main renal vein and vena caval involvement. Based upon this experience, preoperative angiography is not routinely recommended in patients with renal cell carcinoma but may be necessary in selected cases when CT is equivocal or when better definition of vascular anatomy is required.