Accurate measurement of renal mass size is crucial in the management of renal cancer. With the burdensome cost of imaging yet its need for management, a better understanding of the variability among patients when determining mass size remains of urgent importance.
Current guidelines on optimal imaging are limited, especially with respect to body mass index (BMI). The aim of this study is to discern which modalities accurately measure renal mass size and whether BMI influences such accuracy.
A multi-institutional chart review was performed for adult patients undergoing partial or radical nephrectomy between 2018 and 2021, with 236 patients ultimately included. Patients were categorized by BMI (BMI 1: 18.5-24.9, BMI 2: 25-29.9, BMI 3: 30-34.9, and BMI 4: ≥ 35). The greatest mass lengths were compared between the pathology report and the following: computerized tomography (CT), renal ultrasound, and magnetic resonance imaging (MRI).
The difference between greatest length on CT with contrast and MRI were significantly different when compared to pathologic measurement. BMI groups 3 and 4 were found to have a significant difference in size estimates compared to BMI 2 for CT with contrast. No difference was found between size estimates by BMI group for any other imaging modality.
CT with contrast becomes less accurate at estimating mass size for patients with BMI > 30. While contrast-enhanced CT remains a vital imaging modality for tissue enhancement in the context of unknown renal masses, caution must be used for mass size estimation in the obese population.
International urology and nephrology. 2024 Mar 18 [Epub ahead of print]
Young Son, Mark E Quiring, Raeann M Dalton, Brian Thomas, Noah Davidson, Dayna DeVincentz, Collin Payne, Sahil H Parikh, Benjamin A Fink, Thomas Mueller, Gordon Brown
Department of Urology, Jefferson Health New Jersey, 18 E Laurel Rd, Stratford, NJ, 08084, USA. ., Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA., School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA., Lake Erie College of Osteopathic Medicine, Erie, PA, USA., College of Science and Mathematics, Rowan University, Glassboro, NJ, USA., College of Osteopathic Medicine, Nova Southeastern University, Tampa Bay, FL, USA., Department of Urology, Jefferson Health New Jersey, 18 E Laurel Rd, Stratford, NJ, 08084, USA.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/38499727