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Comparison of 16-MDCT and MRI for Characterization of Kidney Lesions

Department of Radiology, Technische Universitaet Munichen, Ismaninger Strasse 21, Munich, Germany, 81675.

OBJECTIVE. The objective of our study was to compare the diagnostic performance of 16-MDCT with that of MRI in the characterization of kidney lesions.

SUBJECTS AND METHODS. Twenty-eight patients with kidney lesions detected with sonography and requiring further evaluation were examined. MDCT was performed in the unenhanced, arterial, and portal venous phases. MRI was performed at 1.5 T with T2- and T1-weighted and dynamic gadolinium-enhanced sequences. Consensus reading was done by two radiologists. Image quality was rated on a four-point scale. Classification of lesions as surgical or nonsurgical was done with five levels of confidence, and it was required that a definite diagnosis be assigned to each lesion. The 1997 TNM classification was used for staging. Statistical analysis was done by receiver operating characteristic analysis or paired Student's t test. Histologic or follow-up findings at least 12 months after the primary diagnosis served as the standard of reference.

RESULTS. The image quality of MDCT (mean grade, 2.79 on a 0-3 scale) was superior to that of MRI (1.93; p < 0.01). The area under the curve for differentiating surgical from nonsurgical lesions was 0.979 for MDCT and 0.957 for MRI with resulting sensitivity and specificity values of 92.3% and 96.3% for MDCT and 92.3% and 91.3% for MRI. Sensitivity and specificity for definite classification of the lesions were 93.8% and 68.4% for MDCT and 93.8% and 71.4% for MRI.

CONCLUSION. Both MDCT and MRI are excellent for differentiating surgical from nonsurgical kidney lesions. Both methods have low specificity for the differentiation of benign from malignant lesions.

Keywords: CT technique • genitourinary tract imaging • kidney • MDCT • MRI

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