Correlation between radiological and histopathological findings in patients undergoing nephrectomy for presumed renal cell carcinoma on computed tomography scan at Grey's Hospital
SA j. radiol
;
22(1): 1-8, 2018. ilus
Article
Dans Anglais
| AIM
| ID: biblio-1271345
RESUMO
Background:
The incidence of renal cell carcinoma (RCC) is increasing globally owing to the increased use of cross-sectional imaging. Computed tomography (CT) scan is the modality of choice in the diagnosis and pre-operative assessment of RCC. Nephrectomy is the standard treatment for RCC and pre-surgery biopsy is not routinely practised. The accuracy of CT diagnosis and staging in a South African population has not been established.Objectives:
To determine the accuracy of CT scan in the diagnosis and pre-operative staging of RCC at Grey's Hospital.Methods:
A retrospective chart review was performed; CT scan reports and histopathological results of adult patients who underwent nephrectomy for presumed RCC on CT scan between January 2010 and December 2016 were compared.Results:
Fifty patients met the inclusion criteria for the study. CT significantly overestimated the size of renal masses by 0.7 cm (p = 0.045) on average. The positive predictive value of CT for RCC was 81%. Cystic tumours and those 4 cm and smaller were more likely to be benign. CT demonstrated good specificity for extra-renal extension, vascular invasion and lymph node involvement, but poor sensitivity.Conclusion:
In our South African study population, CT is accurate at diagnosing RCC, but false-positives do occur. Non-enhancing or poorly enhancing, cystic, fat-containing and small lesions (4 cm or smaller) are more likely to be benign and ultrasound-guided biopsy should be considered to avoid unnecessary surgery. CT assessment of extra-renal extension and vascular invasion is challenging and additional imaging modalities such as magnetic resonance imaging (MRI) venogram, duplex Doppler ultrasound or Positron emission tomographycomputed tomography (PET/CT) may be beneficial
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Indice:
AIM (Afrique)
Sujet Principal:
Patients
/
République d'Afrique du Sud
/
Néphrocarcinome
/
Tomodensitométrie
/
Néphrectomie
Type d'étude:
Étude pronostique
Pays comme sujet:
Afrique
langue:
Anglais
Texte intégral:
SA j. radiol
Année:
2018
Type:
Article
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