Accuracy of multidetector CT scans in staging of renal carcinoma

The 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.

In 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.

A 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.

The multi planar reconstruction capability of multidetector-row CT allowed good specificity in predicting renal vein, IVC involvement, capsular invasion and nodal disease.