J Korean Soc Radiol.  2009 Feb;60(2):109-116. 10.3348/jksr.2009.60.2.109.

Diagnostic Performance of Multidetector-Row CT for Predicting the Preoperative Staging of Renal Cell Carcinoma

• Kim CK
• Choi D
• Park BK
• Kang TW
• Kim JH

• KMID: 2002978
• DOI: http://doi.org/10.3348/jksr.2009.60.2.109

Abstract

PURPOSE
We assessed the diagnostic performance of multidetector-row computed tomography (MDCT) for preoperatively predicting the T-staging of renal cell carcinoma (RCC).
MATERIALS AND METHODS
All the MDCT studies were performed using a 16- or 40-slice MDCT scanner and the three-phase CT images, including unenhanced, corticomedullary and delayed nephrographic phase images. For the differentiation between < or = T2 disease and > or = T3 disease, a four-point scale was used and a score of more than three was considered indicative of > or = T3 disease. The imaging findings were compared with the surgical specimens with using the 2002 TNM staging system. Statistical analysis was performed using McNemar's test, kappa statistics and receiver operating characteristic (ROC) analysis.
RESULTS
The 144 RCCs consisted of 72 T1a, 31 T1b, 16 T2, 13 T3a and 12 T3b. For all the T-staging, the accuracies of MDCT were excellent (> or = 87%) for both readers. For predicting > or = T3 disease on MDCT, the area under the receiver operating characteristics curve (Az) for both readers was 0.898 and 0.896, respectively. The interreader agreement was almost perfect (kappa= 0.853).
CONCLUSION
MDCT was accurate for preoperatively predicting the T-staging of RCCs, with almost perfect interreader agreement.

MeSH Terms

Carcinoma, Renal Cell
Multidetector Computed Tomography
Neoplasm Staging
ROC Curve
Tomography, X-Ray Computed