The value of computed tomography in the diagnosis and monitoring of renal carcinoma is reviewed on the basis of personal experience with 405 patients and a comparison with the literature. CT is of high sensitivity and specificity in the detection of small renal carcinomas as well in differential diagnosis and may remain the favored imaging method in this field. In local pretherapeutic tumor staging, CT, particularly dynamic studies, has achieved an accuracy of more than 90%. This method has its limits in precise estimation of the cranio-caudal extension of the tumor; complementary information is expected from MRI. In the monitoring of nonsurgically, treated renal tumors, CT is indicated where sonographic findings are doubtful only. In the diagnosis of small recurrent renal tumors, CT is more sensitive and should be a regular element in follow-up studies.
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