There is no relevant literature suggesting that US offers any additional benefit over conventional CT or MRI of the abdomen in the initial staging of RCC, and thus, this method is not included in the guidelines from the EAU and NCCN [5,13]. However, intraoperative US may be helpful in performing partial nephrectomy, especially in patients with endophytic renal tumors [72,73]. Staging of Renal Cell Carcinoma Variant 2: Renal cell carcinoma. Contraindication to both iodinated CT and gadolinium-based MR 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 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 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.
Staging of Renal Cell Carcinoma. There is no relevant literature suggesting that US offers any additional benefit over conventional CT or MRI of the abdomen in the initial staging of RCC, and thus, this method is not included in the guidelines from the EAU and NCCN [5,13]. However, intraoperative US may be helpful in performing partial nephrectomy, especially in patients with endophytic renal tumors [72,73]. Staging of Renal Cell Carcinoma Variant 2: Renal cell carcinoma. Contraindication to both iodinated CT and gadolinium-based MR 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 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 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.