Title: Evaluating the Accuracy of Computed Tomography in the Diagnosis of Renal Masses
Authors: Gayathri A R, Beena Sebastian, Sajitha K
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.21
Abstract
Objectives: To evaluate the accuracy of Computed Tomography in differentiation of benign and malignant renal masses.
Methodology: Aprospective study was conducted in the Department of Radio diagnosis, Govt. Medical College, Kottayam over a period of 18 months from May 2015 to November 2016. Study population included 46 patients who were referred for CT scan of abdomen with clinical suspicion of renal mass.
Results: Of the 46 cases studied, majority (73.9%) were malignant renal masses among which Renal Cell Carcinoma was the predominant diagnosis (50%). The diagnostic accuracy of multiphasic Computed Tomography was found to be 86.9% for differentiation of benign and malignant renal masses with a sensitivity of 94%, specificity of 66.6%, Positive Predictive Value of 88.9% and Negative Predictive Value of 80%.
Some of the CT parameters were found to have statistically significant association with various renal masses. Irregular shape and ill defined parenchymal interface of renal masses on CT were found to have statistically significant association with malignancies and RCCs. Exophytic growth pattern, heterogenous and early washout enhancement pattern & presence of perilesional collaterals were also found to be associated with RCCs. Intrarenal location of lesion along with renal pelvic / ureteric involvement was found to be significantly associated with TCC.
Conclusion: Computed Tomography is an accurate imaging modality for the evaluation of renal masses and thus an important prerequisite for proper patient management.
Keywords: Computed Tomography; Renal masses; Renal Cell Carcinoma.
References
1. allwein-Prettner L, Flöry D, Rotter CR, Pogner K, Syré G, Fellner C, et al. Assessment and characterisation of common renal masses with CT and MRI. Insights Imaging. 2011 Jul 17;2(5):543–56.
- Millet I, Doyon FC, Hoa D, Thuret R, Merigeaud S, Serre I, et al. Characterization of Small Solid Renal Lesions: Can Benign and Malignant Tumors Be Differentiated With CT? Am J Roentgenol. 2011 Oct 1;197(4):887–96.
- Türkvatan A, Akdur PO, Altinel M, Olçer T, Turhan N, Cumhur T, et al. Preoperative staging of renal cell carcinoma with multidetector CT. Diagn Interv Radiol Ank Turk. 2009 Mar;15(1):22–30.
- Ng CS, Wood CG, Silverman PM, Tannir NM, Tamboli P, Sandler CM. Renal Cell Carcinoma: Diagnosis, Staging, and Surveillance. Am J Roentgenol. 2008 Oct 1;191(4):1220–32.
- Bajwa R, Sandu P, Saggar K. Helical CT Evaluation of Renal Mass Lesions: A Prospective Study. J Indian Acad Clin Med [Internet]. [cited 2017 Jun 11]; Available from: http://www.academia.edu/22104312/Helical_CT_Evaluation_of_Renal_Mass_Lesions_A_Prospective_Study
- Dongre1 AH, Rangankar 2 VP, Singh3 H. Renal Mass, CT Characterization, Renal Cell Carcinoma. CT EvalCharact Ren MASSES [Internet]. 2015 Nov 20 [cited 2017 May 23];(9607). Available from: https://jemds.com/latest-articles.php?at_id=9607
- Songib N-A, Nazri M, Yaakup NA, Nor HM, Sun Z. Multiphase renal CT in the evaluation of renal masses: is the nephrographic phase necessary? Clin Imaging. 2013 Nov;37(6):1037–42.