Diagnostic Accuracy of Contrast-Enhanced Computed Tomography in Small Renal Cell Carcinoma

Abstract

Objective: To determine the diagnostic accuracy of contrast-enhanced computed tomography (CECT) in the diagnosis of small renal cell carcinoma (RCC), using histopathology as the reference gold standard.

Methodology: This cross-sectional study was conducted in the Department of Radiology, Civil Hospital, Karachi, from September 2020 to March 2021. All clinically suspected patients with small RCC, of either gender, were included. Contrast-enhanced CT of the abdomen was performed using intravenous contrast material. Imaging was acquired in the axial plane with multiplanar reformations in sagittal and coronal planes, with the patient in the supine position. A diagnosis of small RCC was made based on CT findings, and histopathology results were collected. Sensitivity, specificity, and diagnostic accuracy of contrast-enhanced CT of the abdomen were calculated using histopathology as the gold standard.

Results: Of the participants, 68.2% were male and 31.8% were female. The mean age was 56.54 ± 9.45 years. The mean duration of symptoms was 7.88 ± 2.31 weeks. The mean renal mass diameter was 2.54 ± 0.92 cm. Overall, 45.5% of patients were diagnosed with RCC on CT scan, while 52.7% were confirmed by histopathology. CECT demonstrated a sensitivity of 82.76%, specificity of 96.15%, positive predictive value (PPV) of 96%, negative predictive value (NPV) of 86.33%, and an overall diagnostic accuracy of 89.09% for diagnosing small RCC.

Conclusion: Contrast-enhanced CT offers high sensitivity and specificity for the accurate diagnosis of small renal mass