CT characterization of "indeterminate" renal masses: targeted or comprehensive scanning?
OBJECTIVE
A comprehensive renal mass evaluation CT protocol is usually performed for simultaneous characterization and staging of incidentally discovered renal masses considered indeterminate on ultrasound (US). The purpose of the study was to determine if a comprehensive examination is appropriate in these patients.


METHODS
The authors performed a retrospective review of 100 patients (mean age, 61 years) with 102 sonographically indeterminate renal masses and who were referred to undergo CT for lesion characterization. Lesions were classified according to surgical histology or imaging follow-up evaluation. Statistical analysis was performed.


RESULTS
Thirteen lesions (12.7%) in 11 (11%) patients (mean age, 59 years) were malignant. Eighty-seven lesions (85.3%) in 87 patients (87%; mean age, 62 years) were benign. Two lesions (1.96%) in two patients (2%) remained indeterminate.


CONCLUSIONS
Although comprehensive renal mass evaluation protocol provides a more thorough patient evaluation, only a small fraction of indeterminate renal masses seen on US are malignant. The authors' results suggest a targeted renal CT imaging protocol for evaluation of indeterminate renal masses incidentally discovered on US.
Prasad
Srinivasa R
SR
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Division of Abdominal Imaging and Intervention, Ellison 234, 55 Fruit Street, Boston, MA 02114, USA.
Saini
Sanjay
S
Stewart
Sarah
S
Hahn
Peter F
PF
Halpern
Elkan F
EF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*