ROLE OF MULTIDETECTOR CT IN CHARACTERIZATION OF RENAL MASSES WITH HISTOPATHOLOGY AS GOLD STANDARD

Abstract

Objective: To determine the diagnostic accuracy of multidetector computed tomography (MDCT) in characterization of renal masses with histopathology as gold standard.

Study Design: Cross sectional validation study.

Study Setting: This study was conducted at the Department of Diagnostic Radiology, Shifa International Hospital, Islamabad

Study Duration: Six Months (August 24 to January ‘25).

Methodology: 140 patients with suspected renal masses either clinically or on ultrasound who proceeded with computed tomography (CT) scan as well as biopsy were included in the study. After taking informed consent, data was collected prospectively. Histopathology reports of all the patients were followed. A 2 x2 two table was constructed for positive/negative malignant renal masses on CT versus histopathology. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated.

Results: MDCT had Sensitivity of 98.3%, specificity of 81.8%, and positive predictive value of 96.6%, negative predictive value of 90.0% while diagnostic accuracy of 95.7% in detecting renal masses. Most common type of malignancy in our study population was renal cell carcinoma (RCC) seen in 83.8 % of the patients. Clear cell type of RCC was the most common seen in 85 (74.6 %) patients. Fumarate hydratase deficient was the least common subtype of RCC seen in 1 (0.9%) patient.

Conclusion: MDCT is an excellent diagnostic tool in characterization of renal masses and can replace invasive procedures like biopsy or nephrectomies when not required.