Diagnostic accuracy of contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging of small renal masses in real practice: Sensitivity and specificity according to subjective radiologic interpretation

Jae Heon Kim, Hwa Yeon Sun, Jiyoung Hwang, Seong Sook Hong, Yong Jin Cho, Seung Whan Doo, Won Jae Yang, Yun Seob Song

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36 Scopus citations

Abstract

Background: The aim of this study was to investigate the diagnostic accuracy of contrast-enhanced computed tomography (CT) and contrast-enhanced magnetic resonance imaging (MRI) of small renal masses in real practice. Methods: Contrast-enhanced CT and MRI were performed between February 2008 and February 2013 on 68 patients who had suspected small (≤4 cm) renal cell carcinoma (RCC) based on ultrasonographic measurements. CT and MRI radiographs were reviewed, and the findings of small renal masses were re-categorized into five dichotomized scales by the same two radiologists who had interpreted the original images. Receiver operating characteristics curve analysis was performed, and sensitivity and specificity were determined. Results: Among the 68 patients, 60 (88.2 %) had RCC and eight had benign disease. The diagnostic accuracy rates of contrast-enhanced CT and MRI were 79.41 and 88.23 %, respectively. Diagnostic accuracy was greater when using contrast-enhanced MRI because too many masses (67.6 %) were characterized as "4 (probably solid cancer) or 5 (definitely solid cancer)." The sensitivity of contrast-enhanced CT and MRI for predicting RCC were 79.7 and 88.1 %, respectively. The specificities of contrast-enhanced CT and MRI for predicting RCC were 44.4 and 33.3 %, respectively. Fourteen diagnoses (20.5 %) were missed or inconsistent compared with the final pathological diagnoses. One appropriate nephroureterectomy and five unnecessary percutaneous biopsies were performed for RCC. Seven unnecessary partial nephrectomies were performed for benign disease. Conclusions: Although contrast-enhanced CT and MRI showed high sensitivity for detecting small renal masses, specificity remained low.

Original languageEnglish
Article number260
JournalWorld Journal of Surgical Oncology
Volume14
Issue number1
DOIs
StatePublished - 12 Oct 2016

Bibliographical note

Funding Information:
This research was supported by the Next-generation Medical Device Development Program for Newly-Created Market of the National Research Foundation (NRF) funded by the Korean government, MSIP (No. 2015M3D5A1065926) and supported by Soonchunhyang University Research Fund.

Publisher Copyright:
© 2016 The Author(s).

Keywords

  • Computed tomography
  • Magnetic resonance imaging
  • Renal cell carcinoma

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