Imaging in Suspected Renal-Cell Carcinoma: Systematic Review

Area of Science:

• Radiology
• Oncology
• Diagnostic Imaging

Background:

• Renal cell carcinoma (RCC) diagnosis and staging are critical for effective treatment.
• Accurate imaging is essential for identifying and characterizing kidney tumors.

Purpose of the Study:

• To systematically assess the diagnostic performance of contrast-enhanced computed tomography (CT) versus other imaging modalities for diagnosing and staging adult renal cell carcinoma (RCC).

Main Methods:

• A comprehensive literature search identified 40 studies with 4354 patients.
• Data on CT, magnetic resonance imaging (MRI), positron emission tomography-CT, and ultrasound (US) were extracted and analyzed.
• Median sensitivity and specificity were calculated for each modality.

Main Results:

• Contrast-enhanced CT demonstrated 88% sensitivity and 75% specificity; MRI showed 87.5% sensitivity and 89% specificity.
• Staging accuracy for CT was 87% sensitivity and 74.5% specificity; MRI showed 90% sensitivity and 75% specificity.
• Contrast-enhanced ultrasound (CEUS) offered high sensitivity (93%) but mediocre specificity; unenhanced US was poor. PET-CT showed good accuracy with limited data.

Conclusions:

• Contrast-enhanced CT and MRI are the mainstays for RCC diagnosis and staging, offering comparable high accuracy.
• Combining CT or MRI with CEUS may be beneficial for specific clinical questions.
• Further large prospective studies are needed to enhance the evidence quality.