Comparative Value of Radiology Methods in the Diagnostics of Renal Tumors

Aim: Comparative value of radiology methods in the diagnostics of renal tumors. Objectives: 1. To evaluate the incidence of distribution of renal tumors according to the age and gender of the patients. 2. To determine the most common types of benign and malignant renal tumors. 3. To review the diagnostic potentiality of US in usage as a selective abdominal radiology examination while detecting pathological changes of kidneys. 4. To evaluate CT value in the estimation of pathological changes of kidneys. 5. To evaluate other radiology methods (MRI, conventional angiography, etc.) significance in diagnostics of renal tumors. Methods: The study enrolled patients who underwent diagnostics and treatment of renal tumors at the Urology department of the Hospital of Lithuanian University of Health Sciences (LUHS) Kauno Klinikos in the period of 2016-2017. The following data was gathered from 276 case histories and later analyzed: age, gender, records of US, CT, MRI and other radiology examinations, records of performed surgeries, diagnosis, and findings of histology tests. Results: 33.0% of the subjects belong to the age group of 60-70 years. There was a statistically significantly (p<0.01) higher proportion of subjects in men (166 (60.1%)) than women (110 (39.9%)). The most common renal tumors were clear renal cell carcinoma (69.6% of the cases), papillary renal cell carcinoma (7.2%), and oncocytoma (6.5%). The most frequently used radiology methods were CT (94.9% subjects), US (70.3% subjects), and MRI (17.4% subjects). CT examination showed the most sensitive results in diagnostics of clear renal cell carcinoma – 57.6% sensitivity. MRI examination results were the most sensitive in diagnostics of chromophobe renal cell carcinoma - 100% sensitivity. Conclusions: 1. Most of the renal tumor patients belong to the age group of 60-70 years. Men had a statistically significantly higher incidence of renal tumors (p<0.01) and accounted for 60.1% of all subjects. 2. 89.1% of all the renal tumors were malignant and only 10.9% were benign. The most commonly detected renal tumor subtype was clear renal cell carcinoma. 3. 70.3% of all study patients underwent US examination. In all the cases of suspicion of renal tumors, US was the first-choice examination. 4. CT examination was performed for 94.9% of all the study patients. The diagnostic value of CT varies depending on the subtype of renal tumors. 5. MRI was chosen in diagnostics of 17.4% patients. The value of this diagnostic method also varies depending on the subtype of renal tumors. 6. CT and MRI have comparable value in diagnostics of renal tumors. CT was statistically significantly more sensitive (p=0.02) in the diagnosis of clear renal cell carcinoma, MRI was statistically significantly more sensitive (p