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Related Experiment Videos

Small (< or = 3-cm) renal masses: detection with CT versus US and pathologic correlation

C A Jamis-Dow1, P L Choyke, S B Jennings

  • 1Department of Diagnostic Radiology, National Institutes of Health, Bethesda, Maryland 20892-1182, USA.

Radiology
|March 1, 1996
PubMed
Summary

Computed tomography (CT) and ultrasound (US) have limitations in detecting small renal lesions, especially those under 1 cm. Neither CT nor US demonstrated superiority in characterizing lesions 3 cm or less in patients with hereditary kidney cancer.

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Area of Science:

  • Medical Imaging
  • Nephrology
  • Oncology

Background:

  • Small renal lesions are common in hereditary kidney cancer syndromes.
  • Accurate detection and characterization of these lesions are crucial for patient management.
  • Computed tomography (CT) and ultrasound (US) are primary imaging modalities used for renal lesion assessment.

Purpose of the Study:

  • To evaluate the diagnostic performance of CT and US in detecting and characterizing small renal lesions.
  • To compare the sensitivities of CT and US for small renal masses.
  • To correlate imaging findings with surgically verified pathological data.

Main Methods:

  • Retrospective analysis of 21 patients with von Hippel-Lindau disease or hereditary papillary renal cancer.
  • Patients underwent both CT and US examinations prior to surgical intervention.

Related Experiment Videos

  • Correlation of imaging detection and characterization accuracy with lesion size and surgical outcomes for 205 renal masses (<3 cm in 92%).

    • Main Results:

    • CT and US detection rates varied significantly with lesion size, with lower sensitivity for lesions <10 mm.
    • For lesions 10-35 mm, CT and US correctly characterized morphology in 80% and 82% of cases, respectively.
    • Neither modality was superior for characterizing lesions ≤3 cm, and a substantial proportion of lesions <1 cm were missed by both.

    Conclusions:

    • Both CT and US have limitations in detecting very small renal lesions (<1 cm) in patients with hereditary kidney cancer.
    • Characterization accuracy for lesions ≤3 cm is comparable between CT and US, but neither is definitively superior.
    • Clinical interpretation of CT and US screening in these high-risk patients requires caution due to the potential for missed or mischaracterized small renal lesions.