Incidental detection of preclinical renal tumors with electron beam computed tomography: report of 26 consecutive operated patients.

PURPOSE: The purpose of this work was to describe the positive predictive value of electron beam CT (EBCT) for diagnosis of solid renal tumors.

METHOD: Among 11,932 consecutive patients undergoing screening EBCT, 27 cases met EBCT criteria for solid renal tumors. Twenty-six of 27 patients underwent surgery.

RESULTS: Surgical pathology identified 25 solid renal tumors and 1 adrenal hemorrhage with thrombus. Twenty tumors were classified as T1N0M0, one was T2N0M0, and one was T3aN0M0. All tumor patients are clinically well at 1-41 months (mean 17 months) postoperatively. None of the patients had clinical signs or symptoms characteristic of renal malignancy.

CONCLUSION: EBCT is an effective tool for detection of solid renal tumors in a healthy outpatient population (positive predictive value 0.96). The detection rate is low [0.2% (26/11,932) at our facility] in patients undergoing EBCT for other indications. The cost-effectiveness and sensitivity of this technique for solid renal tumor detection among various populations remain to be determined.