Incidental Detection of Preclinical Renal Tumors with Electron Beam Computed Tomography: Report of 26 Consecutive Operated Patients

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Abstract
The purpose of this work was to describe the positive predictive value of electron beam CT (EBCT) for diagnosis of solid renal tumors. Among 11,932 consecutive patients undergoing screening EBCT, 27 cases met EBCT criteria for solid renal tumors. Twenty-six of 27 patients underwent surgery. Surgical pathology identified 25 solid renal tumors and 1 adrenal hemorrhage with thrombus. Twenty tumors were classified as T1N0M0, one was T2N0M0, and one was T3aN0M0. All tumor patients are clinically well at 1–41 months (mean 17 months) postoperatively. None of the patients had clinical signs or symptoms characteristic of renal malignancy. EBCT is an effective tool for detection of solid renal tumors in a healthy outpatient population (positive predictive value 0.96). The detection rate is low [0.2% (26/11,932) at our facility] in patients undergoing EBCT for other indications. The cost-effectiveness and sensitivity of this technique for solid renal tumor detection among various populations remain to be determined.