Diagnostic Accuracy of Staging Renal Cell Carcinomas Using Multidetector-Row Computed Tomography and Magnetic Resonance Imaging

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Abstract
Objective: The aim of this prospective study is to compare the diagnostic accuracy of multidetector-row computed tomography (CT) and magnetic resonance imaging (MRI) in tumor staging of renal cell carcinomas. Methods: In a prospective study, 82 renal cell carcinomas were assessed for tumor staging before surgery using multidetector-row CT and MRI, the results of which were then correlated to histopathologic staging. Triphasic CT (noncontrast, arterial phase, and parenchymal phase) imaging was performed using multidetector-row CT with a reconstructed slice thickness of 2 mm. In MRI, a transverse T1-weighted gradient echo sequence with and without administration of Gd-DTPA, a transverse T2-weighted respiratory-gated turbo spin echo (TSE) sequence, and a coronal T1-weighted gradient echo sequence with Gd-DTPA were used. In addition, multiphasic 3-dimensional angiography after Gd-DTPA injection and a transverse T1-weighted fat-suppression sequence were performed. Results: With MRI, readers 1 and 2 correctly staged 71 and 64 tumors (overall accuracy of 0.87 and 0.78, respectively) and achieved Mantel-Haenszel χ2 values of 66 and 63 (P < 0.0001). Computed tomography allowed correct staging of 68 and 66 tumors (readers 1 and 2, overall accuracy of 0.83 and 0.80, respectively) with Mantel-Haenszel χ2 values of 54 and 54 for CT staging (P < 0.0001). No statistically significant difference between overall accuracy was found in the χ2 test (P > 0.15). Conclusion: Magnetic resonance imaging and multidetector-row CT with its multiplanar reconstruction capabilities achieve similar accuracy in tumor staging of renal cell carcinomas.