We assessed the diagnostic performance of multidetector-row computed tomography (MDCT) for preoperatively predicting the T-staging of renal cell carcinoma (RCC).

All the MDCT studies were performed using a 16- or 40-slice MDCT scanner and the three-phase CT images, including unenhanced, corticomedullary and delayed nephrographic phase images. For the differentiation between ≤ T2 disease and ≥ T3 disease, a four-point scale was used and a score of more than three was considered indicative of ≥ T3 disease. The imaging findings were compared with the surgical specimens with using the 2002 TNM staging system. Statistical analysis was performed using McNemar's test, κ statistics and receiver operating characteristic (ROC) analysis.

The 144 RCCs consisted of 72 T1a, 31 T1b, 16 T2, 13 T3a and 12 T3b. For all the T-staging, the accuracies of MDCT were excellent (≥ 87%) for both readers. For predicting ≥ T3 disease on MDCT, the area under the receiver operating characteristics curve (Az) for both readers was 0.898 and 0.896, respectively. The interreader agreement was almost perfect (κ= 0.853).

MDCT was accurate for preoperatively predicting the T-staging of RCCs, with almost perfect interreader agreement.