Accuracy of multidetector CT scans in staging of renal carcinoma

AbstractObjectiveThe aim of this study is to determine the diagnostic accuracy of multidetector-row computed tomography (MDCT) compared to histopathological findings in tumor staging of renal cell carcinoma, with the focus on tumor size and stage, renal vein involvement, and peri-renal infiltration.Materials and methodsIn a retrospective study, a total of 98 consecutive patients with renal cell carcinoma were preoperatively assessed for tumor staging using multidetector-row CT. Triphasic CT imaging (i.e., noncontrast, arterial, and parenchymal phase) was performed using multidetector-row CT with the slice thickness of 5 mm and using multi planar reconstructions to define the tumor characteristics. A single blinded reader evaluated the CT scans independently who reviewed the scan on multi planar reconstructions. The results were then correlated with the histopathological results.ResultsA total of 98 renal cell carcinomas were proven on histopathology. There was a significant (p 0.05) difference in the mean maximum radiological and maximum pathological diameter of the tumor with radiological diameter being greater. Twenty seven tumors were down staged and only 1 was up staged. The specificity of CT for capsular invasion, nodal disease and adrenal involvement was 85, 82 and 98% respectively. The specificity was over 97% for tumor thrombus in renal vein and IVC.ConclusionsThe multi planar reconstruction capability of multidetector-row CT allowed good specificity in predicting renal vein, IVC involvement, capsular invasion and nodal disease