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.