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  • SAGE Publications  (2)
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  • SAGE Publications  (2)
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  • 1
    Online Resource
    Online Resource
    SAGE Publications ; 2010
    In:  Acta Radiologica Vol. 51, No. 5 ( 2010-06), p. 581-589
    In: Acta Radiologica, SAGE Publications, Vol. 51, No. 5 ( 2010-06), p. 581-589
    Abstract: Background: Recent technological advances have made whole-body MRI feasible within a reasonable time-frame. The clinical utility of whole-body MRI in patients with renal cell carcinoma has not been evaluated yet. Purpose: To compare the diagnostic accuracy of whole-body MRI and computed tomography (CT) in follow-up of patients with renal cell carcinoma. Material and Methods: In 28 patients with primary renal cell carcinoma a multislice CT scan of the thorax, abdomen, and pelvis, and a whole-body MRI were carried out as part of the postoperative follow-up. A combination of subsequent imaging studies and histology served as standard of reference. Results: MRI demonstrated a significantly better diagnostic accuracy regarding musculoskeletal metastases compared with CT (97.7% vs 82%, P 〈 0.001). In contrast, CT was superior in the detection of pulmonary metastases (88.5% vs 71.9%, P 〈 0.001). Both methods had similar diagnostic performance regarding lymph node metastases (CT, accuracy 82.4%; MRI, accuracy 83.4%, P=0.25). The concordance of both modalities regarding N and M stage was excellent (Cohen's kappa 1.00). In two patients cerebral metastases were revealed by MRI, which led to a change in therapy. Conclusion: At this stage, whole-body MRI cannot be considered an adequate replacement for CT in the follow-up of patients with renal cell carcinoma. Further significant improvement of lung MR protocols is necessary, as CT's sensitivity for pulmonary nodules is clearly superior. In contrast, the main advantage of whole-body MRI is its high diagnostic accuracy for musculoskeletal metastases.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    RVK:
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
    detail.hit.zdb_id: 2024579-8
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  • 2
    Online Resource
    Online Resource
    SAGE Publications ; 2010
    In:  Therapeutic Advances in Urology Vol. 2, No. 1 ( 2010-02), p. 11-17
    In: Therapeutic Advances in Urology, SAGE Publications, Vol. 2, No. 1 ( 2010-02), p. 11-17
    Abstract: The treatment of advanced renal cell carcinoma has been completely changed by the development of new therapeutic modalities during the past 3 years. In this time period six targeted agents have been approved for the treatment of advanced or metastatic disease. Phase 3 data support the use of sunitinib, bevacizumab plus interferon-α and pazopanib for patients with low and intermediate risk of clear-cell renal cell carcinoma. In the pivotal study of temsirolimus a significant longer overall survival compared with interferon-α in high-risk disease including non-clear-cell histology was observed. Patients pretreated with cytokines will benefit from sorafenib and pazopanib while everolimus has been shown to increase significantly progression-free survival after previous anti-angiogenesis therapy. In addition to these phase 3 data-based recommendations, several other factors have to be considered for treatment selection, for example, side effect profile and patients’ comorbidities. Currently, the sequential use of the available targeted drugs and adjuvant treatment are the subject of ongoing clinical trials. However, medical treatment of renal cell carcinoma remains palliative and surgery remains the only curative approach in patients with localized, locally advanced and limited metastatic disease.
    Type of Medium: Online Resource
    ISSN: 1756-2872 , 1756-2880
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
    detail.hit.zdb_id: 2492591-3
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