Renal adenocarcinoma: CT staging of 100 tumors

The preoperative CT scans of 100 pathologically proven renal adenocarcinomas were retrospectively reviewed to assess the accuracy of CT for staging the tumor. Regardless of tumor stage, perinephric extension was assessed with a sensitivity of 46% and a specificity of 98%. The sensitivity of CT in detecting venous invasion (either venous enlargement or thrombus) was 78%, with a specificity of 96%. For detection of metastatic adenopathy, CT had a sensitivity of 83% and specificity of 88%. Adjacent organ invasion was correctly identified in 60% of patients, with a specificity of 100%. Overall, CT correctly staged 91% of patients. If errors associated with perinephric invasion were excluded, CT staging accuracy improved to 96%. CT is useful in staging renal adenocarcinoma. If the renal vein is not well seen, angiography or sonography may be necessary to determine the presence of venous tumor extension.