Mayo Adhesive Probability Score Is an Independent Computed Tomography Scan Predictor of Adherent Perinephric Fat in Open Partial Nephrectomy.
OBJECTIVE
To evaluate predictive radiological elements for adherent perinephric fat (APF) and the Mayo adhesive probability (MAP) score in the setting of open partial nephrectomy, and to assess their reproducibility.


METHODS
We performed a retrospective case-control study involving 86 patients who had open partial nephrectomies performed by a single surgeon between January 1, 2009 and April 1, 2015. Radiological elements were assessed by 4 readers blinded to patient APF status. Univariate and multivariate analyses were performed for all radiological and clinical factors. Reproducibility was analyzed using agreement coefficients.


RESULTS
On univariate analysis for radiological findings, lateral and posterior fat thickness (odds ratio [OR]: 1.084 [1.033, 1.138], P < .001), stranding (OR: 2.179 [1.431, 3.318], P < .001), -80 HU fat area, and the MAP score (OR: 1.797 [1.332, 2.424], P < .001) were predictive of APF. On multivariate analysis, only age and the MAP score remained statistically significant (OR: 1.060 [1.005, 1.118], P = .03; and OR: 1.560 [1.137, 2.139], P = .0058, respectively). The reproducibility of the MAP score was fair (AC1 = 0.367 and kappa F = 0.353), as was that of stranding (AC1 = 0.499, kappa F = 0.376). The agreement was important if we defined a "low" (0 to 3) or "high" (4 or 5) score (AC1 = 0.706 and kappa F = 0.681).


CONCLUSIONS
The MAP score was the element that best predicted APF in our study, although its reproducibility among our readers was only fair. The agreement becomes important if we defined "low or high" score.
Department Urology, Hopital Lyon Sud, Lyon University Hospital, Lyon, France. Electronic address: loganmartin065@gmail.com.
Logan
L
Martin
Department of Radiology, Hopital Edouard Herriot, Lyon University Hospital, Lyon, France.
Olivier
O
Rouviere
Department of Radiology, Hopital Edouard Herriot, Lyon University Hospital, Lyon, France.
Riadh
R
Bezza
Department of Radiology, Hopital Edouard Herriot, Lyon University Hospital, Lyon, France.
Jérôme
J
Bailleux
Hospices Civils de Lyon, EA 7425 HeSPeR, Lyon University Hospital, Lyon, France.
Fatima
F
Abbas
Hospices Civils de Lyon, EA 7425 HeSPeR, Lyon University Hospital, Lyon, France.
Anne-Marie
AM
Schott-Pethelaz
Department Urology, Hopital Lyon Sud, Lyon University Hospital, Lyon, France.
Alain
A
Ruffion
Department Urology, Hopital Lyon Sud, Lyon University Hospital, Lyon, France.
Philippe
P
Paparel
D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D005602:France; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods; D015203:Reproducibility of Results; D012107:Research Design / Q000592:standards*; D012189:Retrospective Studies; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed / Q000379:methods*
D014014:Tissue Adhesives