Diagnostic Accuracy of Contrast-Enhanced Computed Tomography in the Characterization of Cystic Renal Cell Carcinoma

Abstract

Objectives: To determine the diagnostic accuracy of contrast-enhanced computed tomography in characterizing cystic renal cell carcinoma, using histopathology as the gold standard. Methodology: This prospective diagnostic accuracy study was conducted in the Radiology Department of Allied Hospital II, Faisalabad. 33 patients with suspected cystic renal lesions aged ≥18 years undergoing abdominal CT for renal evaluation were included. CT findings were categorized using the Bosniak classification system and compared with histopathological findings. We calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy. We used IBM SPSS version 26.0 to analyze the data. Results: Histopathological findings confirmed cRCC in 20 (60.6%) patients, whereas 13 (39.4%) lesions were benign. Comparison of CECT findings with histopathology showed 19 true positives, 11 true negatives, 2 false positives, and 1 false negative. Consequently, 95.0% sensitivity, 84.6% specificity, 90.5% (PPV), 91.7% (NPV), and 90.9% total diagnostic accuracy was obtained. A statistically significant correspondence (p < 0.001) was seen between the histopathological findings and Bosniak classification, indicating that higher Bosniak categories were strongly associated with malignant cystic renal lesions. Conclusion: This study concluded that CECT showed high diagnostic performance for the characterization of cRCC when compared with histopathology as the gold standard. CECT can be an effective imaging modality to guide appropriate clinical management and surgical decision-making.