Three-dimensional imaging and display of renal tumors using spiral CT: a potential aid to partial nephrectomy.

OBJECTIVE

A new technique for creating three-dimensional (3D) images of renal tumors using contrast-enhanced spiral computed tomography (CT) is described and preliminarily investigated.

METHODS

3D spiral CT was employed in 2 patients before radical nephrectomy and in 5 patients before partial nephrectomy. Preoperative and postoperative image analyses were conducted to evaluate the ability of the images to depict key anatomic relationships in planning partial nephrectomies.

RESULTS

3D spiral CT defined the tumor's location and relationship to the kidney surface better than the tumor's proximity to renal hilar vessels and collecting system. Negative surgical margins were obtained in all 4 patients with renal cell carcinoma, and post-operative serum creatinine remained less than 2 mg/dL in all 5 patients after partial nephrectomy.

CONCLUSIONS

This early experience suggests that 3D spiral CT can help in the planning of partial nephrectomy and in attaining complete resection of renal cell carcinoma while conserving normal renal tissue.