Correlation between radiological and histopathological findings in patients undergoing nephrectomy for presumed renal cell carcinoma on computed tomography scan at Grey’s Hospital

SA Journal of Radiology


 
 
Field Value
 
Title Correlation between radiological and histopathological findings in patients undergoing nephrectomy for presumed renal cell carcinoma on computed tomography scan at Grey’s Hospital
 
Creator Mlambo, Nompumelelo E. Dlamini, Nondumiso N.M. Urry, Ronald J.
 
Subject radiology; urology; oncology renal cell carcinoma; post nephrectomy; CT scan accuracy; histology correlation; CT staging
Description 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 tomography–computed tomography (PET/CT) may be beneficial.
 
Publisher AOSIS
 
Contributor None.
Date 2018-10-10
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — qualitative; observational; analytical; cross sectional
Format text/html application/epub+zip application/xml application/pdf
Identifier 10.4102/sajr.v22i1.1339
 
Source South African Journal of Radiology; Vol 22, No 1 (2018); 8 pages 2078-6778 1027-202X
 
Language eng
 
Relation https://sajr.org.za/index.php/sajr/article/view/1339/2106 https://sajr.org.za/index.php/sajr/article/view/1339/2105 https://sajr.org.za/index.php/sajr/article/view/1339/2107 https://sajr.org.za/index.php/sajr/article/view/1339/2103
 
Coverage Africa; South Africa; Kwa-Zulu Natal; Pietermaritzburg; Greys Hospital. January 2010 - December 20196 age; gender; date of scan and surgery; indication of scan and surgery; CT and histology tumor size; CT tumor characteristics; CT and histology local invasion; vascular invasion and ymph node spread; CT distant metastases; histology - final diagnosis
Rights Copyright (c) 2018 Nompumelelo E. Mlambo, Nondumiso N.M. Dlamini, Ronald J. Urry https://creativecommons.org/licenses/by/4.0