Improving accuracy, reliability, and efficiency of the RENAL nephrometry score with 3D reconstructed virtual imaging.

To clarify the diagnostic performance of the three-dimensional reconstructed virtual image (3D-RVI) in evaluating RENAL nephrometry score (RENAL-NS).

This study included 130 patients who underwent preoperative contrast-enhanced computed tomography (CECT) followed by partial nephrectomy for renal tumors suggestive of renal cell carcinoma.

RENAL-NS was calculated prior to the surgery, and tumor resection was performed referring to the score. We retrospectively reviewed preoperative CECT images. We calculated the inter-observer variability of RENAL-NS using 3D-RVI versus two-dimensional (2D) imaging and compared the ability of RENAL-NS using 3D-RVI versus 2D imaging to predict the risk of opening of the urinary collecting system. We also compared the two modalities for the time required to evaluate RENAL-NS.

RENAL-NS evaluated using 3D-RVI showed a higher inter-observer agreement compared to 2D-imaging (rs = 0.85 vs. rs = 0.65). The "nearness to sinus" score was more strongly associated with the opening of the urinary collecting system when evaluated using 3D-RVI than 2D-imaging (AUC = 0.71 vs AUC = 0.57, p = 0.016). RENAL-NS using 2D-imaging required a significantly longer time compared to 3D-RVI (p = 0.036).

Using 3D-RVI improves the accuracy, reliability and efficiency of RENAL-NS evaluation in preoperative assessment and can play an important role in preoperative assessment and intraoperative navigation.

Urology. 2022 Jan 27 [Epub ahead of print]

Kasumi Kaneko Yoshitomi, Yoshinobu Komai, Tatsuya Yamamoto, Eri Fukagawa, Kosuke Hamada, Yusuke Yoneoka, Motohiro Fujiwara, Ryo Fujiwara, Tomohiko Oguchi, Noboru Numao, Takeshi Yuasa, Shinya Yamamoto, Iwao Fukui, Junji Yonese

Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan., Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan. Electronic address: ., Department of Diagnostic Radiology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.

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