Pietro Lodise, Presenter: Nothing to Disclose

Valeria Panebianco MD, Abstract Co-Author: Nothing to Disclose

Alessandro Cannavale, Abstract Co-Author: Nothing to Disclose

Flavio Barchetti, Abstract Co-Author: Nothing to Disclose

Rocco Papalia, Abstract Co-Author: Nothing to Disclose

Carlo Catalano MD, Abstract Co-Author: Nothing to Disclose

To introduce a novel a segmental anatomy of the kidney integrated with a standardized radiological reporting method to describe small renal masses (<7 cm) location and pathological features.

Sixty patients underwent multiphase (pre-contrast, arterial, parenchimal and escretory phase) MDCT scan with 1 mm acquisitions. We divided the kidney in three portions with perpendicular planes to the line of maximum longitudinal diameter of the kidney. These planes pass through the bottom edge of the upper lip of the renal sinus and the other edge at the top of the lower lip. Hence the kidney was divided into 3 zones (upper, middle, lower) and twelve segments identified with Roman numbers. Two radiologists blindly read all cases according to a standardized report method : tumor size (TD, LD, APD), location in kidney’s segment/s, exophityc growth pattern, collecting system’s relationship and tumor’s feeding arteries (FA). Intra and inter-observer reliability was assessed with k-statistic test.

Sixty-three tumors were diagnosed with the following dimensions: mean±SD): TD =31,9 mm± 12,8 , APD = 31,4 mm ± 13,5 and LD= 32,2 mm ± 13,9. Ten tumors (15.8%) were mono-segmental, 23 tumors (36.5%) involved 2 segments, 18 tumors (28.5%) involved 3 segments, and 12 tumors (19%) involved 4 segments. Mean exophytic percentage of the lesions was 24.9%: 8.6 % of the tumors were > 2/3 exophytic, in 40 % of the tumors the exophytic growth pattern was comprised between 1/3 and 2/3, 36.1% were <1/3 exophytic and 15.2 % were completely endophytic. Dislocation and infiltration of the collecting system was observed in 21 (28.5%) and 16 (25.4%) tumors, respectively. In the remaining 26 tumors mean distance from the collecting system was 7.7 mm. In 39 tumors one FA was detected, in 15 tumors two FAs were detected and in 9 tumors 3 or 4 FAs were detected. Intra and inter-observer reliability resulted as k=0.95 and 0.91 respectively. Mean reporting time was 16±4 mins.

Kidney segmentation and standardized radiological report are a simple and exhaustive manner to describe small renal masses location and provide pointless information for clinical practice.

A standardized report may help the radiologist to categorically describe small renal tumors giving the correct informations to the urologist who has to plan nephron sparing surgery.

Lodise, P, Panebianco, V, Cannavale, A, Barchetti, F, Papalia, R, Catalano, C, Novel Anatomic Kidney Segmentation to Describe Renal Tumors Eligible for Nephron Sparing Surgery: A Comprehensive CT-scan Based Reporting.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044393.html