Diagnostic Accuracy of Computed Tomography Scan in Characterization of Wilms Tumor Taking Histopathology as a Gold Standard
DOI:
https://doi.org/10.66838/Keywords:
Wilms Tumor; Computed Tomography; Histopathology; Diagnostic Accuracy; Pediatric Renal Tumor; Renal MasAbstract
Objective: To determine the diagnostic accuracy of computed tomography in differentiating Wilms tumor from other pediatric renal lesions using histopathology as the reference standard.
Methods: A cross-sectional diagnostic accuracy study was conducted in the Department of Radiology at The Indus Hospital and Health Network. Korangi. Karachi. Pakistan From 9 January 2026 to 9 May 2026. Children aged 6 months to 15 years with suspected renal masses were included. Computed tomography findings were categorized as suggestive of Wilms tumor or a non-Wilms renal lesion and were compared with histopathological diagnoses. Sensitivity. Specificity. Positive predictive value. Negative predictive value and overall diagnostic accuracy were calculated using a two-by-two contingency table.
Results: A total of 88 children were included. Histopathology confirmed Wilms tumor in 62 patients and non-Wilms renal lesions in 26 patients. Computed tomography correctly identified 58 Wilms tumors and incorrectly classified 6 non-Wilms lesions as Wilms tumor. Four Wilms tumors were missed on CT. The sensitivity was 93.5%. Specificity was 76.9%. Positive predictive value was 90.6%. Negative predictive value was 83.3%. Overall diagnostic accuracy was 88.6%.
Conclusion: Computed tomography showed high sensitivity and useful overall diagnostic accuracy in differentiating Wilms tumor from other pediatric renal lesions. However. False-positive and false-negative findings were observed. Histopathological examination remains essential for definitive diagnosis and treatment planning.
