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What Is Sufficient?

Mark A. Benson, MD; John R. Haaga, MD; Martin I. Resnick, MD

Arch Surg. 1989;124(1):71-73.

Abstract
• We retrospectively reviewed the roentgenographic and pathologic staging of 64 patients with renal cell carcinoma to assess the role of the various staging modalities (ie, angiography, venacavography, bone scanning, ultrasound, computed tomography [CT], and magnetic resonance imaging). Specific attention was directed at detecting vena cava thrombus and metastatic bone disease, factors with a significant impact on the therapeutic approach. The findings support the role of CT as the principle tool for overall staging and the observation that venacavography is not indicated if CT has excluded caval thrombus. Similarly, routine bone scans are not warranted in the absence of an elevated alkaline phosphatase level or bone pain. The key to the more efficient utilization of imaging resources is understanding the capabilities of the technology available.

(Arch Surg 1989;124:71-73)

Author Affiliations
From the Division of Urology (Drs Benson and Resnick) and Department of Radiology (Dr Haaga), Case Western Reserve University School of Medicine, Cleveland.

Footnotes
Accepted for publication July 8, 1988.

Read before the Annual Meeting of the Society of Surgical Oncology, New Orleans, May 22, 1988.

Reprint requests to Division of Urology, University Hospitals of Cleveland, 2065 Adelbert Rd, Cleveland, OH 44106 (Dr Resnick).

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