What is renal mass Protocol for CT scan?

The renal mass CT protocol is a multi-phasic contrast-enhanced examination for the assessment of renal masses. It is most often comprised of a non-contrast, nephrogenic phase and excretory phase.

Why do renal CT multiphase?

Multiphase renal CT has been widely used in characterization of renal tumors and preoperative staging of RCC due to its high sensitivity and specificity to detect and characterize the renal lesions [12], [13], [14]. A potential criticism to the four-phase CT protocol is an increase in radiation dose to the patient.

What is nephrogenic phase CT?

The nephrographic phase begins at 80–120 seconds after the start of contrast medium injection. Tubular filtration of contrast material produces homogeneous enhancement of the renal parenchyma. This is the best phase for detection of subtle parenchymal lesions.

What is the most accurate imaging study for characterizing a renal mass?

CT is considered the gold standard for the characterization of renal tumors [28]. Due to its superiority over US and the lesser extent of MRI availability, CT is often the first choice of imaging for evaluation of a renal tumor.

What percentage of renal masses are cancerous?

About 20-30% of “suspicious” kidney tumors when removed prove to be benign! These benign growths include cysts, oncocytomas, angiomyolipomas, and mixed epithelial stromal tumors. Thus, 70-80% of these “small” kidney tumors are cancers and fortunately the majority are “well behaved” (low grade) cancers.

What is considered a large kidney tumor?

Every year in the U.S., more than 67,000 new cases of renal cancer are diagnosed, the majority of which are small masses (under 4 cm). However, large renal masses ≥4 cm still account for a significant number of cases.

What is a 4 phase CT scan?

It involves a non-contrast liver followed by a dedicated late arterial phase, portal venous phase and delayed phase acquisition.

Why creatinine test is important before CT scan?

2.2 Using POC creatinine tests before outpatient contrast-enhanced CT scans in the radiology department could minimise the risk of kidney injury. It could also reduce the number of cancelled scans, which is important for patients.

What are the three phases of CT urogram?

CT urogram technique

The three phases most commonly include a non-contrast phase, a nephrographic phase scanned at 80 to 120 s delay, and an excretory phase scanned at 10–15 min delay (Fig. 1).

Can renal cell carcinoma be diagnosed by CT scan?

The preferred method of imaging renal cell carcinomas is dedicated renal computed tomography (CT). In most cases, this single examination can detect and stage RCC and provide information for surgical planning.

How do you know if a kidney tumor is cancerous?

Ultrasound. Ultrasound can help find a kidney mass and show if it is solid or filled with fluid (kidney tumors are more likely to be solid). Different ultrasound patterns can also help doctors tell the difference between some types of benign and malignant kidney tumors.

How fast can a kidney tumor grow?

Based on the model, the average growth rate of kidney tumors in the study was 2.13 cm/year (SD 1.45 cm/year, range 0.2–6.5 cm/year).

How fast do renal tumors grow?

The growth rate of renal masses in that study was 0.28 cm/year (range 0.09–0.86 cm/year). A somewhat faster growth rate was observed in the subgroup of patients with pathologically confirmed renal cancer (0.4 cm/year, range 0.42–1.6 cm/year).

What are CT phases?


Phase Time from injection
Early systemic arterial phase 15-20 sec
Late systemicarterial phase Sometimes also called “arterial phase” or “early venous portal phase” 35-40 sec
Pancreatic phase 30 or 40 – 50 sec
Hepatic (most accurate) or late portal phase 70-80 sec

What is a delayed phase CT?

delayed phase defines relationship of solid renal mass relationship to collecting system. c. delayed phase facilitates identification of transitional cell carcinoma and traumatic injury. (2) Adrenal nodule characterization. a.

What is normal creatinine level for CT scan?

A normal result is 0.7 to 1.3 mg/dL (61.9 to 114.9 µmol/L) for men and 0.6 to 1.1 mg/dL (53 to 97.2 µmol/L) for women. Women often have a lower creatinine level than men.

Can contrast dye damage kidneys?

For patients with kidney disease and other risk factors, the contrast dye used for visualization during the coronary procedures in the Cath Lab can be difficult for the kidneys and can cause damage, complications and increased length of stay in the hospital.

What is the difference between a CT scan and a CT urogram?

A CT urogram is a test using a CT scan and special dye (contrast medium) to look at the urinary system. The contrast medium helps show up the urinary system more clearly. You have a CT scan of your: kidney.

What is Pyelographic phase?

The pyelographic or excretory phase is present 3 minutes after in- jection of IV contrast material (Fig. 1). In normal kidneys, the three phases of contrast media excretion are always symmet- ric in time of appearance, time of disappear- ance, and density [2].

What does renal cell carcinoma look like on CT scan?

On contrast-enhanced CT scans, RCC is usually solid, and decreased attenuation suggestive of necrosis is often present. Sometimes, RCC is a predominantly cystic mass, with thick septa and wall nodularity. RCC may also appear as a completely solid and highly enhancing mass.

How serious is a tumor on the kidney?

Benign, or noncancerous kidney tumors grow in size but do not spread to other parts of the body and are not usually life-threatening. Surgical removal is the most common treatment and most tumors do you come back.

How long can you live with stage 4 renal cell carcinoma?

Stage 4. More than 10 out of 100 people (more than 10%) survive their cancer for 5 years or more after they are diagnosed. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive.

What size tumor is considered large?

The study defined tumors less than 3 cm as small tumors, and those that are more than 3 cm as large tumors, in 720 EGC patients. Meanwhile, tumors less than 6 cm in size were set as small tumors, while more than 6 cm as large tumors, in 977 AGC patients. The study has acquired the following results.

What are the three phases of CT Urogram?

Why is delayed CT scan done?

The potential benefits of the delayed scan in routine examinations include assessment of adequate renal excretion of IV contrast material and assessment of the liver, spleen, kidneys, collecting systems, adrenal glands, and venous structures in a different phase of enhancement on the delayed scan [6].