Bosniak classification version 2019: a prospective comparison of CT and MRI

Almalki, Yassir Edrees; Basha, Mohammad Abd Alkhalik; Refaat, Rania; Alduraibi, Sharifa Khalid; Abdalla, Ahmed A El-Hamid M; Yousef, Hala Y.; Zaitoun, Mohamed; Elsayed, Saeed Bakry; Alayouty, Nader Ali; Ali, Susan Adil; Alnaggar, Ahmad Abdullah; Saber, Sameh; El-Maghraby, Ahmed Mohamed; Elsheikh, Amgad M.; Radwan, Mohamed; Abdelmegid, Ahmed Gamil Ibrahim; Aly, Sameh Abdelaziz; Shanab, Waleed S. Abo; Obaya, Ahmed A.; Abdelhai, Shaimaa; Elshorbagy, Shereen; Haggag, Yasser M.; Mokhtar, Hwaida M.; Sabry, Nesreen M; Altohamy, Jehan Ibrahim; Abouelkheir, Rasha T.; Omran, Tawfik; Shalan, Ahmed; Algazzar, Youssef H.; Metwally, Maha Ibrahim

doi:10.1007/s00330-022-09044-3

Cited by 7 publications

(11 citation statements)

References 32 publications

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“…The full-text review was conducted among the remaining 44 potential articles, after which 36 articles were excluded for insufficient data or being outside the field of interest (e.g., in terms of inter-reader agreement, growth kinetics, or inclusion of class IIF/III/IV masses only). Ultimately, a total of eight articles comprising 720 patients were included in the current meta-analysis ( 21 – 28 ).…”

Section: Resultsmentioning

confidence: 99%

“…The average tumor size was between 25.4 mm and 65.9 mm, with a malignancy rate of 18.8%–78.1%. Regarding the imaging modalities, four studies reported results from CT ( 21 , 23 , 25 , 28 ),, five reported results from MRI ( 22 , 23 , 25 , 26 , 28 ),, and three reported a combination of results from CT and MRI ( 21 , 24 , 27 ). With respect to the number of radiologists, only one study reported that the images were interpreted by only one reader ( 24 ), whereas in the other seven studies, the images were interpreted by at least two readers.…”

Section: Resultsmentioning

confidence: 99%

“…The overall quality of the included studies was not very high, primarily due to patient selection ( Figure 2 ). In more than half of the studies, the analysis was restricted to cystic renal masses with confirmed pathological results ( 23 , 25 – 28 ), which may have led to selection and verification biases, as those masses under surveillance that did not undergo histological confirmation were not included. Regarding the reference standard, two of the studies used the availability of at least five years of follow-up data, rather than histopathological findings, as the reference standard for some patients ( 21 , 22 ).…”

Section: Resultsmentioning

confidence: 99%

“…We also performed subgroup analyses for various examinations involving CT and MRI, both alone and in combination. Regarding the four studies reporting the diagnostic accuracy of CT, the pooled sensitivity and specificity were 0.86 (95% CI 0.68-0.95) and 0.71 (95% CI 0.61-0.80), respectively (21,23,25,28). For the five studies reporting the diagnostic accuracy of MRI, the pooled sensitivity was comparable (0.87, 95% CI 0.78-0.93) but the specificity was lower (0.67, 95% CI 0.48-0.81) (22,23,25,26,28).…”

Section: Subgroup Analysesmentioning

confidence: 99%

“…Regarding the four studies reporting the diagnostic accuracy of CT, the pooled sensitivity and specificity were 0.86 (95% CI 0.68-0.95) and 0.71 (95% CI 0.61-0.80), respectively (21,23,25,28). For the five studies reporting the diagnostic accuracy of MRI, the pooled sensitivity was comparable (0.87, 95% CI 0.78-0.93) but the specificity was lower (0.67, 95% CI 0.48-0.81) (22,23,25,26,28). Regarding the three studies reporting the diagnostic accuracy of CT in combination with MRI, the pooled sensitivity (0.81, 95% CI 0.70-0.91) was lower than using CT or MRI alone, while the specificity was comparable (0.67, 95% CI 0.61-0.82) (21,24,27).…”

Section: Subgroup Analysesmentioning

confidence: 99%

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Diagnostic performance of the Bosniak classification, version 2019 for cystic renal masses: A systematic review and meta-analysis

Zhang

Dai

2022

Front. Oncol.

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PurposeTo systematically assess the diagnostic performance of the Bosniak classification, version 2019 for risk stratification of cystic renal masses.MethodsWe conducted an electronic literature search on Web of Science, MEDLINE (Ovid and PubMed), Cochrane Library, EMBASE, and Google Scholar to identify relevant articles between June 1, 2019 and March 31, 2022 that used the Bosniak classification, version 2019 for risk stratification of cystic renal masses. Summary estimates of sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR−), and diagnostic odds ratio (DOR) were pooled with the bivariate model and hierarchical summary receiver operating characteristic (HSROC) model. The quality of the included studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool.ResultsA total of eight studies comprising 720 patients were included. The pooled sensitivity and specificity were 0.85 (95% CI 0.79–0.90) and 0.68 (95% CI 0.58–0.76), respectively, for the class III/IV threshold, with a calculated area under the HSROC curve of 0.84 (95% CI 0.81–0.87). The pooled LR+, LR−, and DOR were 2.62 (95% CI 2.0–3.44), 0.22 (95% CI 0.16–0.32), and 11.7 (95% CI 6.8–20.0), respectively. The Higgins I2 statistics demonstrated substantial heterogeneity across studies, with an I2 of 57.8% for sensitivity and an I2 of 74.6% for specificity. In subgroup analyses, the pooled sensitivity and specificity for CT were 0.86 and 0.71, respectively, and those for MRI were 0.87 and 0.67, respectively. In five studies providing a head-to-head comparison between the two versions of the Bosniak classification, the 2019 version demonstrated significantly higher specificity (0.62 vs. 0.41, p < 0.001); however, it came at the cost of a significant decrease in sensitivity (0.88 vs. 0.94, p = 0.001).ConclusionsThe Bosniak classification, version 2019 demonstrated moderate sensitivity and specificity, and there was no difference in diagnostic accuracy between CT and MRI. Compared to version 2005, the Bosniak classification, version 2019 has the potential to significantly reduce overtreatment, but at the cost of a substantial decline in sensitivity.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Subgroup Analysesmentioning

confidence: 99%

Section: Subgroup Analysesmentioning

confidence: 99%

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Diagnostic performance of the Bosniak classification, version 2019 for cystic renal masses: A systematic review and meta-analysis

Zhang

Dai

2022

Front. Oncol.

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Applicability of Bosniak 2019 for renal mass classification on portal venous phase at the era of spectral CT imaging using rapid kV-switching dual-energy CT

Reizine,

Blain,

Pescatori

et al. 2023

Eur Radiol

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Increased prevalence of kidney cysts in individuals carrying heterozygous COL4A3 or COL4A4 pathogenic variants

Furlano,

Pilco-Teran,

Pybus

et al. 2024

Nephrology Dialysis Transplantation

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Background Clinical variability among individuals with heterozygous pathogenic/likely pathogenic (P/LP) variants in the COL4A3/COL4A4 genes (also called autosomal dominant Alport syndrome or COL4A3/COL4A4 related disorder) is huge; many individuals are asymptomatic or show microhematuria, while others may develop proteinuria and chronic kidney disease (CKD). The prevalence of simple kidney cysts (KC) in the general population varies according to age, and patients with advanced CKD are prone to have them. A possible association between heterozygous COL4A3, COL4A4, and COL4A5 P/LP variants and KC has been described in small cohorts. The presence of KC in a multicenter cohort of individuals with heterozygous P/LP variants in the COL4A3/COL4A4 genes is assessed in this study. Methods We evaluated the presence of KC by ultrasound in 157 individuals with P/LP variants in COL4A3 (40.7%) or COL4A4 (53.5%) without kidney replacement therapy. The association between presence of KC and age, proteinuria, eGFR, and causative gene was analyzed. Prevalence of KC was compared with historical case series in the general population. Results Half of the individuals with P/LP variants in COL4A3/COL4A4 showed KC, which is a significantly higher percentage than in the general population. Only 3.8% (6/157) had cystic nephromegaly. Age and eGFR showed an association with the presence of KC (p<0.001). No association was found between KC and proteinuria, sex, or causative gene. Conclusions Individuals with COL4A3/COL4A4 P/LP variants are prone to develop KC more frequently than the general population, and their presence is related to age and to eGFR. Neither proteinuria, sex nor the causative gene influences the presence of KC in these individuals.

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Bosniak classification version 2019: a prospective comparison of CT and MRI

Cited by 7 publications

References 32 publications

Diagnostic performance of the Bosniak classification, version 2019 for cystic renal masses: A systematic review and meta-analysis

Diagnostic performance of the Bosniak classification, version 2019 for cystic renal masses: A systematic review and meta-analysis

Applicability of Bosniak 2019 for renal mass classification on portal venous phase at the era of spectral CT imaging using rapid kV-switching dual-energy CT

Increased prevalence of kidney cysts in individuals carrying heterozygous COL4A3 or COL4A4 pathogenic variants

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