Distinguishing Renal Cell Carcinoma From Other Focal Renal Lesions on Multidetector Computed Tomography

Pornphan Wibulpolprasert; Chompoonuch Thongthong; Bussanee Wibulpolprasert

doi:10.33165/rmj.2020.43.1.176267

Authors

Pornphan Wibulpolprasert Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Chompoonuch Thongthong Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Bussanee Wibulpolprasert Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.33165/rmj.2020.43.1.176267

Keywords:

Renal cell carcinoma, Renal mass, Computed tomography

Abstract

Background: The increased use of imaging modalities has led to a greater incidence in depicting solid renal mass. These lesions comprise a wide spectrum of malignant such as renal cell carcinoma (RCC) and benign histologies.

Objective: To determine the multidetector computed tomography (MDCT) features that discriminate RCC from other focal renal lesions.

Methods: A retrospective review was performed on 148 patients who underwent renal CT scan followed by renal surgery or biopsy during January 2008 to July 2014. Specific predictive MDCT features of RCC were determined by logistic regression analysis. Interobserver agreement (kappa [K] values) was also calculated for each CT feature.

Results: In 148 pathologic proved focal renal lesions, 91 (61.5%) were RCCs and 57 (38.5%) were non-RCCs. RCCs were more likely to be in male patients (OR, 5.39; 95% CI, 2.25 - 12.90), no internal fat component (OR, 46.50; 95% CI, 5.25 - 411.90), locate at peripheral (OR, 7.41; 95% CI, 1.63 - 33.73), and mixed central-peripheral locations (OR, 26.22; 95% CI, 4.23 - 162.58) of the kidney. There was moderate-to-excellent agreement among the readers over all these features (K = 0.43 - 0.91).

Conclusions: Focal renal lesion with no internal fat component in MDCT is the most useful characteristic in differentiating RCCs from others.

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