Journal article
Can Radiologists and Urologists Reliably Determine Renal Mass Histology Using Standard Preoperative Computed Tomography Imaging?
Journal of endourology, Vol.29(4), pp.391-396
04/01/2015
DOI: 10.1089/end.2014.0560
PMID: 25222030
Abstract
Purpose:
To determine the extent to which radiologists and urologists can predict histology using multiphasic CT imaging.
Methods:
Patients with a preoperative multiphasic CT undergoing surgery for a renal mass were identified between 2003 and 2013. Tumors >10 cm, locally advanced or metastatic disease, and patients managed by reviewers were excluded. A survey and deidentified scans were provided to reviewers. Sensitivity and accuracy in predicting histology was calculated for each reviewer. Correlation was assessed by the Fleiss kappa coefficient. Multivariable logistic regression determined factors associated with predictive accuracy for final pathology.
Results:
There were 120 patients who met criteria. Mean tumor size was 3.3 cm; there were 102 (85%) that were malignant, and 73% of these were clear-cell renal-cell carcinoma (RCC). The most common benign histology was angiomyolipoma (
n
=10, 56%) followed by oncocytoma (
n
=5, 28%). Correlation among reviewers was statistically fair for predicting malignant (κ=0.25) and final pathology (κ=0.22). Sensitivity for predicting malignant masses was 90%. Reviewers accurately predicted malignant pathology in 82% of cases and predicted final pathology in 58% of cases. Adjusted for size, scan type, and reviewer, clear-cell RCC
vs
benign histology was associated with 21 times increased odds of accurate pathologic identification (
P
<0.001).
Conclusions:
Urologists and radiologists were able to accurately identify malignant histology in 82% of cases, although sensitivity for malignant histology was 90%. Developing a preoperative nomogram for identification of clear-cell RCC may be feasible and should be further explored.
Details
- Title: Subtitle
- Can Radiologists and Urologists Reliably Determine Renal Mass Histology Using Standard Preoperative Computed Tomography Imaging?
- Creators
- M. Francesca Monn - 1Department of Urology, Indiana University School of Medicine, Department of Urology, Indianapolis, IndianaPaul T Gellhaus - 1Department of Urology, Indiana University School of Medicine, Department of Urology, Indianapolis, IndianaAashish A Patel - 2Department of Radiology, Indiana University School of Medicine, Department of Urology, Indianapolis, IndianaTimothy A Masterson - 1Department of Urology, Indiana University School of Medicine, Department of Urology, Indianapolis, IndianaMark Tann - 2Department of Radiology, Indiana University School of Medicine, Department of Urology, Indianapolis, IndianaRonald S Boris - 1Department of Urology, Indiana University School of Medicine, Department of Urology, Indianapolis, Indiana
- Resource Type
- Journal article
- Publication Details
- Journal of endourology, Vol.29(4), pp.391-396
- Publisher
- Mary Ann Liebert, Inc
- DOI
- 10.1089/end.2014.0560
- PMID
- 25222030
- ISSN
- 0892-7790
- eISSN
- 1557-900X
- Language
- English
- Date published
- 04/01/2015
- Academic Unit
- Urology
- Record Identifier
- 9984051595502771
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