Contraindication only to iodinated CT intravenous contrast. Staging. Bone Scan Whole Body The prevalence of osseous metastases for localized RCC has been shown to be low in patients without symptoms (ie, bone pain) or without laboratory abnormalities suggestive of osseous metastases (ie, elevated serum alkaline phosphatase level) [11,12]. Furthermore, the sites commonly involved by osseous metastases, such as the thoracolumbar spine and ribs, are located in areas covered by chest and abdominal imaging. Thus, even though bone scanning can be helpful to confirm clinically or radiographically suspected metastatic disease, current guidelines from the EAU and NCCN do not support its routine use in the initial staging of asymptomatic RCC [5,13]. Bone Scan Whole Body with SPECT or SPECT/CT Area of Interest The prevalence of osseous metastases for localized RCC has been shown to be low in patients without symptoms (ie, bone pain) or without laboratory abnormalities suggestive of osseous metastases (ie, elevated serum alkaline phosphatase level) [11,12]. Furthermore, the sites commonly involved by osseous metastases, such as the thoracolumbar spine and ribs, are located in areas covered by chest and abdominal imaging. Thus, even though bone scanning can be helpful to confirm clinically or radiographically suspected metastatic disease, current guidelines from the EAU and NCCN do not support its routine use in the initial staging of asymptomatic RCC [5,13]. In patients with RCC with symptoms suspicious for bone metastases, bone scan may be useful. If the bone scan shows areas of abnormal radiotracer uptake suspicious for osseous metastases, SPECT fused with CT can be used to provide detailed anatomic localization of the abnormal radiotracer uptake and further improve the characterization of the nature of the abnormality [14]. CT Abdomen Preoperative imaging of RCC provides critical information on staging and serves as a roadmap to the surgeon.
Staging of Renal Cell Carcinoma. Contraindication only to iodinated CT intravenous contrast. Staging. Bone Scan Whole Body The prevalence of osseous metastases for localized RCC has been shown to be low in patients without symptoms (ie, bone pain) or without laboratory abnormalities suggestive of osseous metastases (ie, elevated serum alkaline phosphatase level) [11,12]. Furthermore, the sites commonly involved by osseous metastases, such as the thoracolumbar spine and ribs, are located in areas covered by chest and abdominal imaging. Thus, even though bone scanning can be helpful to confirm clinically or radiographically suspected metastatic disease, current guidelines from the EAU and NCCN do not support its routine use in the initial staging of asymptomatic RCC [5,13]. Bone Scan Whole Body with SPECT or SPECT/CT Area of Interest The prevalence of osseous metastases for localized RCC has been shown to be low in patients without symptoms (ie, bone pain) or without laboratory abnormalities suggestive of osseous metastases (ie, elevated serum alkaline phosphatase level) [11,12]. Furthermore, the sites commonly involved by osseous metastases, such as the thoracolumbar spine and ribs, are located in areas covered by chest and abdominal imaging. Thus, even though bone scanning can be helpful to confirm clinically or radiographically suspected metastatic disease, current guidelines from the EAU and NCCN do not support its routine use in the initial staging of asymptomatic RCC [5,13]. In patients with RCC with symptoms suspicious for bone metastases, bone scan may be useful. If the bone scan shows areas of abnormal radiotracer uptake suspicious for osseous metastases, SPECT fused with CT can be used to provide detailed anatomic localization of the abnormal radiotracer uptake and further improve the characterization of the nature of the abnormality [14]. CT Abdomen Preoperative imaging of RCC provides critical information on staging and serves as a roadmap to the surgeon.