High-Resolution Multidetector CT in the Preoperative Evaluation of Patients with Renal Cell Carcinoma

Catalano, Carlo; Fraioli, Francesco; Laghi, Andréa; Napoli, Alessandro; Pediconi, Federica; Danti, Massimiliano; Nardis, Piergiorgio; Passariello, Roberto

doi:10.2214/ajr.180.5.1801271

Cited by 172 publications

(98 citation statements)

References 36 publications

(38 reference statements)

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“…Delayed images to show resolution of the filling defect are usually sufficient to confirm the artifactual nature of such pseudothrombosis [39]. High resolution MDCT protocol was proved to be correct in identification of thrombus in renal vein and IVC, with the higher radiation dose to the patient as a main drawback [40].…”

Section: Discussionmentioning

confidence: 99%

Venous spread of renal cell carcinoma: MDCT

et al. 2006

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Section: Discussionmentioning

confidence: 99%

Venous spread of renal cell carcinoma: MDCT

et al. 2006

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“…17 Catalona ve arkadaşları çalışmalarında çoklu dedektörlü BT %95 doğrulukla evreleme yaptıklarını bildirmişlerdir. 18 Çalışmamızda çoklu dedektörlü BT kullanılarak % 75 oranında doğru evreleme yaptığımızı bulduk.…”

Section: Discussionunclassified

Relationship between Radiologic Tumor Size in renal cell carcinoma and pathological size

Budak¹,

Sağlam²,

Köse³

et al. 2013

Sakarya Med J

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Amaç: Böbrek hücreli karsinom tedavisinde tümör boyutu cerrahi tipine karar vermede önemli yer tutar. Böbrek hücreli karsinom olgularında,radyolojik tümör boyutu ile patolojik tümör boyutunun ilişkilerinin ortaya konulmasını amaçladık. Gereç ve Yöntem: Böbrek tümörü tanısıyla radikal nefrektomi veya parsiyel nefrektomi uygulanan 36 olgu retrospektif olarak değerlendirildi. Patoloji sonucu böbrek hücreli kanser olmayan hastalar çalışma dışı bırakıldı. Operasyon öncesi çoklu dedektörlü bilgisayarlı tomografide (BT) ölçülen tümör boyutu ile postoperatif patoloji spesmenindeki gerçek tümör boyutu karşılaştırıldı. Hastalar TNM (2009) sistemine göre üç gruba ayrıldı. Hastalar T1a tümör boyutu 4 cm'den küçük, T1b 4 cm ile 7 cm arasında, T2 7 cm'den büyük olarak 3 grupta değerlendirildi. Bulgular: Preoperatif olarak BT ile ölçülen tümör boyutları 2 ile 14 cm arasında değişmektedir (ortalama 6.8 cm). Postoperatif olarak patolojik gerçek tümör boyutlarının 2 ile 14 cm arasında değişmektedir (ortalama 6,2 cm). Preoperatif BT boyutlarına göre T1a evresinde 4, T1b evresinde 8, T2 evresinde 20 hasta bulundu. Tümörlerin ameliyat sonrası patolojik boyutları değerlendirildiğinde T1a, T1b ve T2'deki hasta sayısı sırasıyla 5, 12 ve 15 olarak değişmiştir. BT ile 7 hasta olduğundan yüksek, 1 hasta düşük evrelenmiştir. BT ile preoperatif tümör evrelemesi % 75 oranında doğrulukla yapılmıştır. Sonuç: Preoperatif radyolojik tümör boyutu patolojik gerçek tümör boyutuna göre daha büyük olabilir. Sadece radyolojik tümör boyutuna bakılarak BHK'in tedavisine karar verilmesi bazı hastaların böbrek koruyucu tedavi şansını kaybetmelerine yol açabilir.

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“…Comparing with the spiral CT used before, MDCT has proved to have higher spatial resolution and better anatomy detail delineation. Catalano reported that MDCT had 95% accuracy for perinephric fat infiltration with sensitivity of 96% and specificity of 93% (7). However, even with MDCT and three dimensional technology, Hallscheidt and Türkvatan suggested the evaluation of renal tumor extension in to perinephric fat remains a difficult task (14,15).…”

Section: Discussionmentioning

confidence: 99%

The accuracy of multidetector Computed Tomography for preoperative staging of renal cell carcinoma

et al. 2012

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ARTICLE INFO _________________________________________________________ ___________________Purpose: The purpose of this study was to evaluate the accuracy of multidetector computed tomography (MDCT) in the preoperative staging of renal cell carcinoma (RCC). Materials and Methods:We retrospectively reviewed the clinical and pathological records of 312 patients with RCC who underwent staging MDCT before surgery. Radiographic findings were compared to the findings at surgery and pathological examination. All staging used 2009 updated TNM classification. Results: The difference in tumor size between radiographic and pathological findings was 0.21cm. In T1a group, the difference was 0.33cm. Agreement between MDCT and histopathological findings was moderate for T staging (Kappa = 0.469), fair for N staging (Kappa = 0.322), and excellent for M staging (Kappa = 0.932). The sensitivity and specificity of MDCT in detecting perinephric fat invasion were 32.26% and 85.87%, in detecting tumor thrombosis were 84% and 100%, in detecting adrenal gland invasion were 60% and 95.79%, in detecting lymph node involvement were 50% and 96.36%, in detecting distant metastasis were 100% and 99.67%, respectively. In regard to stage grouping, 237 of 314 patients were correctly staged by MDCT, with an overall accuracy of 75.48%. Conclusions: MDCT with a dynamic contrast protocol is able to delineate RCC with high accuracy. However, a great portion of tumors were overstaged by MDCT because of overestimation of tumor size and poor visualization of infiltration of the perinephric fat. In addition, nodal metastatic lesion evaluation relies on node size only and remains a difficult task.

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High-Resolution Multidetector CT in the Preoperative Evaluation of Patients with Renal Cell Carcinoma

Abstract: High-resolution MDCT is accurate in the preoperative evaluation of patients with renal cell carcinoma.

Cited by 172 publications

References 36 publications

Venous spread of renal cell carcinoma: MDCT

Venous spread of renal cell carcinoma: MDCT

Relationship between Radiologic Tumor Size in renal cell carcinoma and pathological size

The accuracy of multidetector Computed Tomography for preoperative staging of renal cell carcinoma

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