PURPOSE: To redefine and evaluate the computed tomographic criteria for the diagnosis of renal oncocytoma (RO) for which renal sparing surgery should be preferred. MATERIAL AND METHOD: Retrospective study of 57 patients with 69 RO. Macroscopic and histological correlation was obtained in all cases. A double blinded comparative study was made of 60 renal tumors (containing adenocarcinomas and oncocytomas) larger than 3 cm in diameter in order to evaluate the redefined CT diagnostic criteria. RESULTS: Among RO larger than 3 cm in diameter, 55% presented a sharply defined low attenuation scar on post-contrast scans at the tubular nephrographic phase, central or eccentric, with homogeneous attenuation throughout the remainder of the hypervascular tumor which was classified in 3 different groups. The use of our CT diagnostic criteria gave a statistically significant (p < 0.05) Kappa index of inter-observer concordance of 0.71 and a specificity of 96% for the diagnosis of RO. CONCLUSION: Our redefined computed tomographic criteria for the diagnosis of renal oncocytoma, eventually associated with renal biopsy, should increase the indications for renal sparing surgery for RO larger than 3 cm in diameter.
PURPOSE: To redefine and evaluate the computed tomographic criteria for the diagnosis of renal oncocytoma (RO) for which renal sparing surgery should be preferred. MATERIAL AND METHOD: Retrospective study of 57 patients with 69 RO. Macroscopic and histological correlation was obtained in all cases. A double blinded comparative study was made of 60 renal tumors (containing adenocarcinomas and oncocytomas) larger than 3 cm in diameter in order to evaluate the redefined CT diagnostic criteria. RESULTS: Among RO larger than 3 cm in diameter, 55% presented a sharply defined low attenuation scar on post-contrast scans at the tubular nephrographic phase, central or eccentric, with homogeneous attenuation throughout the remainder of the hypervascular tumor which was classified in 3 different groups. The use of our CT diagnostic criteria gave a statistically significant (p < 0.05) Kappa index of inter-observer concordance of 0.71 and a specificity of 96% for the diagnosis of RO. CONCLUSION: Our redefined computed tomographic criteria for the diagnosis of renal oncocytoma, eventually associated with renal biopsy, should increase the indications for renal sparing surgery for RO larger than 3 cm in diameter.
Authors: Albert El Hajj; Ruban Thanigasalam; Isabelle Boulay; Vincent Molinié; Bernard Escudier; Hervé Baumert Journal: Can Urol Assoc J Date: 2014 Jan-Feb Impact factor: 1.862