Table 1.
Tumour characteristics and the odds of local invasion by renal cell carcinoma on CT
| Tumour characteristica | Venous invasion | Sinus fat invasion | Perinephric fat invasion | κ (95% CI) |
|---|---|---|---|---|
| Tumour necrosisb | ||||
| Number of cases | 13/30 | 21/30 | 10/30 | |
| OR (95% CI), p-value | 0.95 (0.45–2), 0.9 | 0.94 (0.5–1.8), 0.8 | 0.38 (0.18–0.85), 0.01 | 0.61 (0.45–0.67) |
| Irregular tumour edgec | ||||
| Number of cases | 22/24 | 34/24 | 23/24 | |
| OR (95% CI), p-value | 3.1 (1.5–6.4), 0.007 | 1.8 (1.03–3.14), 0.04 | 3.2 (1.6–6.4), 0.001 | 0.5 (0.38–0.62) |
| Tumour reaches up to the perirenal fasciad | ||||
| Number of cases | 13/15 | 21/15 | 15/15 | |
| OR (95% CI), p-value | 2.6 (1.1–6.1), 0.02 | 2.2 (1.05–4.5), 0.04 | 2.8 (1.3–6.4), 0.01 | 0.46 (0.3–0.6) |
| Tumour reaches up to the sinus structurese | ||||
| Number of cases | 26/53 | 64/53 | 25/53 | |
| OR (95% CI), p-value | 1.4 (0.71–2.65), 0.35 | 3.4 (1.86–6.1), 0.001 | 1.17 (0.61–2.24), 0.6 | 0.42 (0.29–0.49) |
| Thickened perirenal fasciaf | ||||
| Number of cases | 19/17 | 23/17 | 19/17 | |
| OR (95% CI), p-value | 3.7 (1.7–8), 0.0008 | 2.14 (1.1–4.3), 0.03 | 3.5 (1.63–7.5), 0.001 | 0.24 (0.01–0.34) |
| Accentuated perinephric septationg | ||||
| Number of cases | 20/25 | 37/25 | 20/25 | |
| OR (95% CI), p-value | 2.5 (1.2–5.1), 0.01 | 2.8 (1.5–5.1), 0.001 | 2.4 (1.17–4.8), 0.02 | 0.09 (0.02–0.17) |
| Accentuated perinephric strandingh | ||||
| Number of cases | 29/50 | 50/50 | 33/50 | |
| OR (95% CI), p-value | 1.9 (0.1–3.7), 0.05 | 1.8 (1.1–3.2), 0.03 | 1.6 (0.86–2.9), 0.4 | 0.21 (0.09–0.32) |
| Increased perinephric vascularityi | ||||
| Number of cases | 33/52 | 54/52 | 29/52 | |
| OR (95% CI), p-value | 2.5 (1.2–5), 0.008 | 2.1 (1.18–3.6), 0.01 | 1.1 (0.63–2.12), 0.65 | 0.19 (0.1–0.28) |
| Perinephric nodulesj | ||||
| Number of cases | 3/1 | 4/1 | 3/1 | |
| OR (95% CI), p-value | 7.5 (0.7–74), 0.08 | 5.6 (0.6–51), 0.12 | 17 (0.86–336), 0.06 | 0.2 (0.1–0.4) |
| Calcification | ||||
| Number of cases | 13/30 | 21/30 | 10/30 | |
| OR (95% CI), p-value | 0.95 (0.45–2), 0.9 | 0.94 (0.5–1.8), 0.8 | 0.38 (0.18–0.85), 0.01 | 0.65 (0.5–0.8) |
CI, confidence interval; OR, odds ratio.
The definition of each tumour characteristic studied is given below. The figure for number of cases relates to the number of times both readers cited that the given CT characteristic was present. The first figure relates to the number of times this was seen in those with pathological evidence of venous invasion, sinus fat or perinephric fat invasion as appropriate. The second figure is the number of times the same CT characteristic was noted in those without invasive disease. From these figures, the odds ratio was calculated (see text for further details).
An irregular, poorly enhancing and heterogeneous cavity within the tumour on post-contrast studies.
Irregular or poorly defined edge of the tumour when compared with the adjacent or contralateral normal renal capsule or sinus structures.
The tumour edge is inseparable from the anterior or posterior renal fascia.
Tumour abuts and/or invades the central sinus structures (e.g. calyx/infundibulum/renal pelvis) with no definable intervening normal renal parenchyma.
Perirenal fascia subjectively thicker when compared with the contralateral perirenal fascia.
Subjectively increased linear structures perpendicular to the renal outline when compared with the contralateral perinephric space.
Subjectively increased linear structures parallel to the renal outline when compared with the contralateral perinephric space.
Perinephric vascularity subjectively greater than the contralateral perinephric space.
Discrete nodules within the confines of the perinephric space, but not medial to the renal hila (which were interpreted as lymph nodes).