Literature DB >> 28268233

Does Computed Tomography Still Have Limitations to Distinguish Benign from Malignant Renal Tumors for Radiologists?

Toshitaka Shin1, Vinay A Duddalwar, Osamu Ukimura, Toru Matsugasumi, Frank Chen, Nariman Ahmadi, Andre Luis de Castro Abreu, Hiromitsu Mimata, Inderbir S Gill.   

Abstract

OBJECTIVES: To evaluate the current accuracy of CT for diagnosing benign renal tumors.
MATERIALS AND METHODS: We retrospectively reviewed 905 patients who underwent preoperative CT followed by surgical resection. The final pathology was benign in 156 patients (17%). After exclusions, 140 patients with 163 benign tumors were included and 3 sets of the CT interpretations by radiologists with varying levels of experience were analyzed.
RESULTS: The histological breakdown was as follows: oncocytomas (54.6%), angiomyolipomas (AMLs; 30.7%), renal cysts (8.0%), other miscellaneous benign tumors (6.7%). The sensitivities of diagnosing oncocytomas were 3.4, 9.0, and 13.5% in primary radiological reports, second blinded reviews, and third non-blinded reviews, respectively (p = 0.055). The sensitivities of diagnosing AMLs were 46.0, 58.0, and 62.0% in the 3-sets of CT interpretations, respectively (p = 0.246). As for renal cysts, the sensitivities were 69.2, 92.3, and 100% in the 3-sets of CT interpretations, respectively (p = 0.051). In primary reports, the positive predictive values were 95.8% in lipid poor (lp)-AMLs, 60.0% in oncocytomas, 69.2% in renal cysts, respectively (p < 0.05).
CONCLUSIONS: Current conventional CT imaging still has limitations in differentiating oncocytomas and lp-AMLs from renal cell carcinomas, even when images were re-examined by experienced radiologists.
© 2017 S. Karger AG, Basel.

Entities:  

Keywords:  Angiomyolipoma; Benign tumor; CT; Oncocytoma; Renal tumor

Mesh:

Year:  2017        PMID: 28268233      PMCID: PMC9084480          DOI: 10.1159/000460303

Source DB:  PubMed          Journal:  Urol Int        ISSN: 0042-1138            Impact factor:   2.089


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