Objective: The aim of this prospective study is to compare the diagnostic accuracy of multidetector-row computed tomography (CT) and magnetic resonance imaging (MRI) in tumor staging of renal cell carcinomas.Methods: in a prospective study, 82 renal cell carcinomas were assessed for tumor staging before surgery using multidetector-row CT and MRI, the results of which were then correlated to histopathologic staging. Triphasic CT (noncontrast, arterial phase, and parenchymal phase) imaging was performed using multi detector-row CT with a reconstructed slice thickness of 2 mm. In MRI, a transverse T1-weighted gradient echo sequence with and without administration of Gd-DTPA, a transverse T2-weighted respiratory-gated turbo spin echo (TSE) sequence, and a coronal T1-weighted gradient echo sequence with Gd-DTPA were used. In addition, multiphasic 3-dimensional angiography after Gd-DTPA injection and a transverse T1-weighted fat-suppression sequence were performed.Results: With MRI, readers 1 and 2 correctly staged 71 and 64 tumors (overall accuracy of 0.87 and 0.78, respectively) and achieved Mantel-Haenszel X-2 values of 66 and 63 (P < 0.0001). Computed tomography allowed correct staging of 68 and 66 tumors (readers 1 and 2, overall accuracy of 0.83 and 0.80, respectively) with Mantel-Haenszel X-2 values of 54 and 54 for CT staging (P < 0.0001). No statistically significant difference between overall accuracy was found in the X-2 test (P > 0. 15).Conclusion: Magnetic resonance imaging and multidetector-row CT with its multiplanar reconstruction capabilities achieve similar accuracy in tumor staging of renal cell carcinomas.

Entspechend der durch die Sonographie vermuteten Tumorstadien und der geplanten Therapie müssen CT und MRT optimal angewendet werden.