Vol. 6, Issue 4, Part A (2020)

Objective: In our study we aim to determine the diagnostic value of multidetector CT scan in in detection of renal sinus fat invasion in RCC patients taking histopathology as gold standard.

Material and Methods: All the patients with diagnosed RCC (stage T1a, T1b, T2 and T3a) were included in our study. The preoperative CT scans of all the patients were assessed for the presence of renal sinus fat invasion by two experienced radiologists. The results were evaluated for sensitivity, specificity, positive and negative predictive value taking histopathology as gold standard.

Results: A total 143/284 (51.4%) patients were at stage T3a out of which renal sinus fat invasion was seen in 117/143 (82%) patients. The multidetector enhancement Ct scan findings for renal sinus fat invasion by two radiologists depicted a mean sensitivity of 88%, specificity 73%, 52% positive predictive value and 95% negative predictive value. The size, laterality and polarity did not show a significant correlation (p>0.05)

Conclusion: MDCT is a useful tool in the exclusion of renal sinus fat invasion owing to its high negative predictive value. Although it has a good sensitivity for renal sinus fat involvement however due to low specificity and positive predictive value it cannot be totally relied upon for invasion. Other factors like size, irregular tumor margins, nodular enhancement of renal sinus fat and location of tumor lesion should also be correlated.