title: Small (< or = 3-cm) renal masses: detection with CT versus US and pathologic correlation.
abstract: OBJECTIVE
  To determine the sensitivities of computed tomography (CT) and ultrasound (US) for detection and characterization of surgically verified small renal lesions.
  
  
  METHODS
  Twenty-one patients with von Hippel-Lindau disease or hereditary papillary renal cancer underwent CT and US before partial nephrectomy or enucleation; 205 renal masses were removed (92% were <3 cm). Detection rates and accuracy of CT and US in the characterization of renal morphology were correlated with lesion size.
  
  
  RESULTS
  CT and US detection rates for lesions of 0-5 mm were respectively 47% and 0%; 5-10 mm, 60% and 21%; 10-15 mm, 75% and 28%; 15-20 mm, 100% and 58%; 20-25 mm, 100% and 79%; and 25-30 mm, 100% and 100%. Among the lesions 10-35 mm, 80% and 82% were correctly characterized with CT and US, respectively.
  
  
  CONCLUSIONS
  A substantial proportion of lesions under 1 cm were not detected with either modality. Neither CT nor US was superior in the characterization of lesions 3 cm or less. CT and particularly US screening studies in patients with von Hippel-Lindau disease should be interpreted cautiously because missed or mischaracterized small renal lesions are a frequent problem in these patients.
authors.affiliation: Department of Diagnostic Radiology, National Institutes of Health, Bethesda, Maryland 20892-1182, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Jamis-Dow
authors.forename: P L
authors.initials: PL
authors.lastname: Choyke
authors.forename: S B
authors.initials: SB
authors.lastname: Jennings
authors.forename: W M
authors.initials: WM
authors.lastname: Linehan
authors.forename: K N
authors.initials: KN
authors.lastname: Thakore
authors.forename: M M
authors.initials: MM
authors.lastname: Walther
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D006623:von Hippel-Lindau Disease / Q000000981:diagnostic imaging / Q000473:pathology