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Kidney Cancer Diagnosis

Kidney cancer can be very difficult to identify and detect on routine physical examination. Kidney cancer can arise from the parenchyma (the portion of kidney that filters the blood) or the collecting system (the portion of the kidney that funnels the urine to the bladder). To confirm the presence and extent of kidney cancer, clinicians at Columbia University Department of Urology at NewYork-Presbyterian Hospital use the latest laboratory testing and diagnostic imaging technologies including:

  • Urinalysis to Diagnosis Kidney Cancer: Doctors examine the urine under a microscope to look for any abnormal cells.
  • Cystoscopy and Retrograde Pyelography to Diagnosis Kidney Cancer: If doctors suspect that a kidney tumor is arisng from the collecting system, they may examine the patient using cystoscopy and retrograde pyelography . Using a cystoscope, an instrument consisting of a slender tube with a lens and light that is placed into the kidney through the urethra, the doctor can pass a small catheter into the opening of the ureter (the tube that carries urine form the kidney to the bladder), inject dye, and take X-ray pictures of the entire collecting system to check for possible cancers.
  • Biopsy to Diagnosis Kidney Cancer: Doctors rarely examine a sample of kidney tissue (biopsy) for tumors because a negative biopsy does not always rule out a diagnosis of cancer. In some kidney tumors portions of the tumor may appear benign while other areas are cancerous. If doctors do perform a biopsy, most often they do so through the skin using ultrasound or CT guidance.
  • Intravenous Pyelogram (IVP) to Diagnosis Kidney Cancer: Doctors perform this exam by injecting a dye into the bloodstream, which travels to the kidneys, ureters, and bladder to more clearly outline these organs on x-ray. IVP has been largely replaced by CT scans because the CT scane creates a computer enhanced reconstruction of the entire urinary tract and more accurately identifies small tumors.
  • CT Scan to Diagnosis Kidney Cancer: This imaging technology allows the organs of the body to be examined very closely, to check for evidence of a tumor in the kidney as well as in other organs such as the lungs. In patients with normal kidney function and no allergy to intravenous dyes, doctors administer an intravenous dye that better visualizes the urinary tract. It is considered the best test to determine the presence of a kidney tumor.
  • Renal Ultrasound to Diagnosis Kidney Cancer: This test uses sound waves to distinguish between cancerous masses and fluid-filled cysts, which are not cancerous.
  • Magnetic Resonance Imaging (MRI) to Diagnosis Kidney Cancer: MRI uses magnetic waves to image the kidneys and can be used to detect kidney tumors or to check for the presence of a tumor in the blood vessels of the kidneys.
  • Blood Tests to Diagnosis Kidney Cancer: Doctors analyze the blood for abnormal levels of creatinine, a sign of impaired kidney function, or abnormal levels of liver enzymes, which may suggest that cancer has spread to the liver.
  • Renal Scan to Diagnosis Kidney Cancer: This test helps to determine how well the kidneys are functioning.
  • Venogram/Arteriogram to Diagnosis Kidney Cancer: This specialized imaging test of the arteries and veins connected to the kidneys is used to identify the presence of cancer.
  • Bone Scan to Diagnosis Kidney Cancer: This test may be advisable to determine whether the kidney cancer has spread to the bones.