title: Clinical versus Pathologic staging of Renal Tumors: Role of Multi-Detector CT Urography.
abstract: BACKGROUND
  Our ability to diagnose renal cell carcinoma (RCC) has increased in the past 30 years as a result of the extensive application of imaging techniques, such as ultrasonography, computed tomography, and magnetic resonance imaging. Multi-detector computed tomography (MDCT) remains the most appropriate imaging modality for the diagnosis and staging of RCC. The aim of this work was to compare the findings of MDCT with surgical pathology to determine the accuracy of delineating tumor size, localization, organ confinement, lymph node metastases, and the extent of tumor thrombus in the renal vein and inferior vena cava.
  
  
  METHODS
  The clinical, surgical, and anatomo-pathologic records of 99 patients treated by nephrectomy (radical or partial) for solid renal tumors at Theodor Bilharz Research Institute and Nasser Institute from 2005 to 2011 were reviewed retrospectively. All cases were staged pre-operatively with abdominal MDCT (pre- and post-contrast enhancement) in addition to the routine biochemical, hematological, and radiological work-up. The tumors' histologic types were determined according to the WHO classification of renal tumors in adults in 2004, and staging was updated to the TNM 2010 system. Data were analyzed using the t-test.
  
  
  RESULTS
  The mean age was 52 (range 21-73). Seventy-eight patients were males, and 21 patients were females (Male/Female ratio: 3.7:1). There were no significant differences in the mean tumor size between radiographic and pathologic assessments in different tumor stages. The overall incidence of lymph node invasion in surgical specimens was 76%, whereas MDCT showed a positive incidence in 68.4% of cases (false negative result in 7 cases, 7.6%).
  
  
  CONCLUSIONS
  Our findings indicated that MDCT urography is an accurate method to estimate renal tumor size, lymph node, vascular and visceral metastases preoperatively. Also, preoperative staging of renal tumors with MDCT represents a valuable and accurate tool.
authors.affiliation: Urology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Ahmed I
authors.initials: AI
authors.lastname: Kamel
authors.affiliation: Urology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Badawy
authors.affiliation: Urology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Hossam
authors.initials: H
authors.lastname: Elganzoury
authors.affiliation: Urology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Elkhouly
authors.affiliation: Urology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Khalid
authors.initials: K
authors.lastname: Elesaily
authors.affiliation: Urology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: S
authors.initials: S
authors.lastname: Eldahshan
authors.affiliation: Urology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Mohamed A A
authors.initials: MA
authors.lastname: Ismail
authors.affiliation: Radiology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Mostafa F
authors.initials: MF
authors.lastname: Elshafie
authors.affiliation: Radiodiagnosis department, Al Azhar University, Cairo, Egypt.
authors.forename: Emam M
authors.initials: EM
authors.lastname: Abdel Aziz
authors.affiliation: Urology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Ahmed G
authors.initials: AG
authors.lastname: El Baz
authors.affiliation: Urology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Mamdouh A
authors.initials: MA
authors.lastname: Roshdy
authors.affiliation: Urology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Tarek R
authors.initials: TR
authors.lastname: El Leithy
authors.affiliation: Urology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Samir
authors.initials: S
authors.lastname: Ghobashy
authors.affiliation: Urology department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Kamal
keywords: Multi-Detector CT Urography; renal cell carcinoma; staging