title: [Comparison of imaging methods for diagnosis of renal tumors and their calcifications].
abstract: BACKGROUND
  To establish the best methodology for diagnosis and management of patients with solid and complex renal masses by comparing the costs and benefits of different imaging methods and to improve differential diagnosis of these benign and malignant lesions, particularly by investigating tumour calcifications.
  
  
  METHODS
  We performed a prospective study on 31 patients with solid or complex masses by submitting them to Abdominal Ultrasonography (US), Doppler Ultrasonography of the renal mass (US Dop), Computed Tomography (CT), and Magnetic Resonance Imaging (MRI).
  
  
  RESULTS
  We found 28 patients with malignant and three with benign masses. Of the 28 malignant, 17 showed calcifications at CT; 16 central and one was of the pure peripheral curvilinear type (egg shell). Excretory Urography (IVP) had a significantly lower detection rate for central calcifications than both US and CT. Benign and malignant masses appeared as described in literature, with US, CT and MRI showing high sensitivity and specificity in renal tumor diagnosis. The exception was US Dop where we obtained lower sensitivity for the characterization of malignant tumor flow.
  
  
  CONCLUSIONS
  In this series we were surprised to find that CT revealed central calcifications in 51.6% of patients, all with malignant lesions, while, literature reports a frequency of calcification in renal cell carcinoma between 8 and 22%, in studies using abdominal films and EU (IVP). This finding is of great importance when we consider that these calcifications occur particularly in malignant neoplasms. As a result of comparing these different imaging methods we have developed a better methodology for renal tumor investigation.
authors.affiliation: Faculdade de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP. sribeiro@fmb.unesp.br
authors.forename: Sergio Marrone
authors.initials: SM
authors.lastname: Ribeiro
authors.forename: Sergio Aron
authors.initials: SA
authors.lastname: Ajzen
authors.forename: José Carlos Souza
authors.initials: JC
authors.lastname: Trindade
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002277:Carcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000592:standards; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000592:standards; D014463:Ultrasonography; D014567:Urography / Q000379:methods