Imaging features of renal cell carcinoma differential diagnosis, staging, and posttreatment evaluation

With the widespread use of ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI), there has been an increase in the detection of various subtypes of renal cell carcinomas (RCCs) and benign renal tumors. The differentiation of RCCs from benign tumors such as fat-poor angiomyolipoma and oncocytoma is very important to prevent unnecessary surgery. In addition, the recent progress of therapies to treat RCCs, including nephronsparing surgery, percutaneous ablative procedures, and targeted antiangiogenic therapies, has increased the need for the accurate determination of subtypes and staging. With the development of imaging modalities, there have been significant improvements in correlating preoperative imaging with pathologic characteristics. Many studies performed within the last two decades have helped to clarify diagnostic imaging clues for both cystic and solid renal tumors. In this chapter, we discuss the current status of US, CT, and MRI for the detection and differential diagnosis of renal tumors as well as staging, postprocedural imaging, and imaging for the targeted antiangiogenic treatment of RCC.