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Purpose This study aimed to evaluate the diagnostic performance of multidetector computed tomography (MDCT) for preoperative evaluation of perinephric fat invasion in patients with renal cell carcinomas (RCCs). Methods A total of 408 consecutive patients with surgically confirmed RCC who underwent MDCT were included in this study. Image analysis was first performed with axial-only CT images. A second analysis was then performed with both axial and coronal CT images. A qualitative analysis was then conducted by 2 reviewers who reached consensus. The reference standard was pathologic evaluation. Results The areas under the curve of the receiver operating characteristic analysis were 0.786 and 0.877 for axial-only images and 0.805 and 0.836 for combined images in both readers. The area under the curve of tumor size was 0.833, a similar value to that of the reviewers. In multivariate analysis, tumor size, a linear-nodular or nodular type of fat infiltration, and an irregular tumor margin were independent predicting factors for perinephric fat invasion. Conclusions The MDCT shows relatively high diagnostic performance in detecting perinephric fat invasion of RCC, but suffers from a relatively low positive predictive value. Tumor size, fat infiltration with a nodular appearance, and an irregular tumor margin were predictors for perinephric invasion.

Although tumor size is a prognostic factor in cervical cancer patients, its role in the diagnosis of lymph node metastasis is unclear. We therefore evaluated the diagnostic value of tumor and lymph node size compared with lymph node size alone in the detection of metastatic lymph nodes in patients with early-stage cervical cancer.We retrospectively evaluated 699 patients with International Federation of Obstetrics and Gynecology stage IB1-IIA cervical carcinoma who underwent magnetic resonance imaging before lymphadenectomy involving all visible lymph nodes in the surgical fields. Seven nodal groups were evaluated: para-aortic, both common iliac, both external iliac, and both internal/obturator areas. Pathologic evaluation was the diagnostic standard. The largest short-axis diameter of lymph nodes in each region and the largest tumor diameters were measured in magnetic resonance images. The value of additional information from magnetic resonance images was evaluated by receiver operating characteristic curve analysis.Of the 699 patients, 108 (15.8%) had lymph node metastases. The areas under the curve for measurements of lymph node size, tumor size, and both were (A) 0.635, (B) 0.706, and (C) 0.742, respectively (A vs B, P = 0.006; A vs C P < 0.001; B vs C, P = 0.002).This study illustrates that magnetic resonance imaging measurements of tumor size and tumor size plus lymph node size showed a higher diagnostic performance than lymph node size alone in predicting lymph node metastasis in patients with early-stage cervical cancer.

Purpose The purpose of this article was to retrospectively evaluate computed tomographic (CT) findings in patients with pathologically proved clear cell carcinoma of the ovary. Methods CT scans of seven patients (age range, 28-79 years; mean age, 46 years) with nine lesions of histologically proved primary ovarian clear cell carcinoma of the ovary were retrospectively evaluated by two radiologists in consensus. Scans were evaluated for the laterality, size, mass characteristic, margin, attenuation of the cystic portion, internal architecture, and presence of lumen protruding mass. Results Tumors were unilateral in five patients. The average size of the tumors was 8.6 cm (range, 2.6-12.1 cm). All the masses showed mainly cystic appearance. All nine masses had smooth margin. Average attenuation of the cystic portion of the masses was 24.2 HU (Hounsfield unit) (range, 13-34 HU). Tumors usually appeared as unilocular cystic mass (n=6). Lumen protruding masses appeared in seven tumors. Conclusion On CT scans, primary ovarian clear cell carcinomas appeared as large unilocular, mainly cystic, smooth marginated mass with lumen protruding solid portion and high-attenuated cystic portion.

Objective: The computed tomography (CT) findings of ovarian metastases from colon cancer were evaluated and were compared with those of primary malignant ovarian tumors. Methods: Sixteen patients with 21 masses from coloncancer and 20 patients with 31 primary malignant ovarian tumors were included in this study. The CT findings (laterality, size, margin, shape, mass characteristic, strong enhancement of cyst wall, enhancement of solid portion, amount of ascites, peritoneal seeding, lymph node enlargement, and metastasis) and ages of the patients in both groups were compared. Univariate analysis, the Pearson Χ 2 test, and the independent-samples t test were used to distinguish them. Results: A smooth margin of the tumor (odds ratio = 24.3, 95% confidence interval: 2.9-204.2) and cystic nature of the mass (Pearson Χ 2 = 12.96, P = 0.005) were strong predictors of ovarian metastasis from colon cancer. Conclusion: Ovarian metastases from colon cancer show a smooth margin and more cystic nature on CT compared with primary malignant ovarian tumors.

Objective To determine the accuracy of the preoperative staging of uterine cervical cancer by magnetic resonance (MR) imaging in 115 patients in a prospective study. Methods A prospective study was performed in 115 patients who underwent MR imaging at 1.5 T before surgery or biopsy. Histopathologic findings were correlated with MR imaging results for all patients. Results The accuracy of preoperative tumor staging by MR imaging in the 115 patients was 77%. In terms of the evaluation of parametrial status, this study had an accuracy of 94% and a sensitivity of 38%. The accuracy and sensitivity of MR imaging for vaginal invasion were 81% and 87%, respectively. In terms of lymph node metastasis, this study had an accuracy of 97% and a sensitivity of 36%. Conclusion Magnetic resonance imaging has high accuracy in the preoperative staging of uterine cervical cancer.