title: Comparison of radiographical imaging modalities for measuring the diameter of renal masses: is there a sizeable difference?
abstract: OBJECTIVE
  •To determine which imaging modality (magnetic resonance imaging, MRI; computed tomography, CT; ultrasonography, US) best predicted pathological tumour size before radical or partial nephrectomy.
  
  
  METHODS
  •The clinicopathological data of 776 patients who underwent radical or partial nephrectomy were retrospectively reviewed in the context of the radiological modality used for preoperative diagnosis. •The maximum reported diameter of the tumour was compared with the maximum diameter of the tumour after resection. Data were analyzed by a paired Student's t-test, correlation and logistic regression analysis.
  
  
  RESULTS
  •In total, 717 patients had available data for analysis, including 414 CT scans, 121 ultrasonographs and 455 MRIs. When tumour size was compared with preoperative tumour size on ultrasonography, CT and MRI, there was no significant differences between the estimated preoperative tumour size and pathological tumour size (CT: P= 0.56, MRI: P= 0.62, ultrasonography: P= 0.55). Tumour size was also well correlated with all three modalities.
  
  
  CONCLUSIONS
  •All three standard renal imaging modalities appear to accurately predict pathological tumour size. •These data are relevant to the interpretation and comparison of treatment strategies, such as active surveillance protocols and ablative therapy, where pathological size is not available. •Furthermore, lack of inferiority of ultrasonography in predicting pathological tumour size affords opportunities for the reduction of patient radiation exposure and for cost containment.
authors.affiliation: Department of Urology, University of California-Irvine, Orange, CA, USA. pmucksav@uci.edu
authors.forename: Phillip
authors.initials: P
authors.lastname: Mucksavage
authors.forename: Alexander
authors.initials: A
authors.lastname: Kutikov
authors.forename: Laurie
authors.initials: L
authors.lastname: Magerfleisch
authors.forename: Keith
authors.initials: K
authors.lastname: Van Arsdalen
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Wein
authors.forename: Parvati
authors.initials: P
authors.lastname: Ramchandani
authors.forename: S Bruce
authors.initials: SB
authors.lastname: Malkowicz
mesh_terms: D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009392:Nephrectomy; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden; D014463:Ultrasonography