Comparison of the Diagnostic Performance of Contrast-enhanced Ultrasound with That of Contrast-enhanced Computed Tomography and Contrast-enhanced Magnetic Resonance Imaging in the Evaluation of Renal Masses: A Systematic Review and Meta-analysis

Stroszczynski

2020

Section: Introductionmentioning

confidence: 99%

Contrast enhanced ultrasonography (CEUS) to detect abdominal microcirculatory disorders in severe cases of COVID-19 infection: First experience

Stroszczynski

2020

“…The unique signals from microbubbles can be separated from background tissues, allowing for the specific detection of blood flow within perfused tissues. CEUS can definitively confirm simple cysts via the lack of enhancement and may help to characterize solid renal lesions based on differences in lesional versus renal cortical perfusion [17,18]. Figures 1 and 2 illustrate the performance of CEUS compared with traditional grayscale ultrasound by identifying enhancement within a renal mass.…”

Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%

“…According to several reports, the sensitivity and specificity of CEUS for malignancy in a cystic renal mass was comparable to CECT and MRI [19,[21][22][23][24][25][26][27][28]. Additionally, CEUS was reported to perform at least as well as, if not better than, CECT and contrast-enhanced MRI (CEMR) in the classification of benign versus malignant renal masses [17,[22][23][24][29][30][31]. Furrer et al performed a meta-analysis on 1290 patients harboring 1342 cystic or solid renal masses, comparing the performance of CEUS to CECT and CEMR in the detection of benign versus malignant histology.…”

Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%

Expanding the Role of Ultrasound for the Characterization of Renal Masses

Roussel

Campi

Bertolo

et al. 2022

JCM

The incidental detection of renal masses has been steadily rising. As a significant proportion of renal masses that are surgically treated are benign or indolent in nature, there is a clear need for better presurgical characterization of renal masses to minimize unnecessary harm. Ultrasound is a widely available and relatively inexpensive real-time imaging technique, and novel ultrasound-based applications can potentially aid in the non-invasive characterization of renal masses. Evidence acquisition: We performed a narrative review on novel ultrasound-based techniques that can aid in the non-invasive characterization of renal masses. Evidence synthesis: Contrast-enhanced ultrasound (CEUS) adds significant diagnostic value, particularly for cystic renal masses, by improving the characterization of fine septations and small nodules, with a sensitivity and specificity comparable to magnetic resonance imaging (MRI). Additionally, the performance of CEUS for the classification of benign versus malignant renal masses is comparable to that of computed tomography (CT) and MRI, although the imaging features of different tumor subtypes overlap significantly. Ultrasound molecular imaging with targeted contrast agents is being investigated in preclinical research as an addition to CEUS. Elastography for the assessment of tissue stiffness and micro-Doppler imaging for the improved detection of intratumoral blood flow without the need for contrast are both being investigated for the characterization of renal masses, though few studies have been conducted and validation is lacking. Conclusions: Several novel ultrasound-based techniques have been investigated for the non-invasive characterization of renal masses. CEUS has several advantages over traditional grayscale ultrasound, including the improved characterization of cystic renal masses and the potential to differentiate benign from malignant renal masses to some extent. Ultrasound molecular imaging offers promise for serial disease monitoring and the longitudinal assessment of treatment response, though this remains in the preclinical stages of development. While elastography and emerging micro-Doppler techniques have shown some encouraging applications, they are currently not ready for widespread clinical use.

“… 3,7 CEUS also showed better accuracy than CT in assessing Bosniak categorization-related features such as internal septa, parietal thickening, mural nodules, and contrast-enhancement. 9,10 A recent metanalysis by Furrer et al 11 showed 85 vs 79% pooled accuracy in characterizing complex renal cysts for CEUS vs CT/MRI, respectively. Several studies also found CEUS to be effective in assessing malignant incidental renal findings, with approximately 95% accuracy for masses presenting as indeterminate on CT, 3 96% sensitivity/100% specificity for masses of unclear solid nature on MRI, 12 and 100% sensitivity/96.6% specificity for indeterminate or cystic renal lesions found on ultrasound, CT or MRI.…”

Section: Introductionmentioning

confidence: 99%

Role of contrast-enhanced ultrasound in assessing indeterminate renal lesions and Bosniak ≥2F complex renal cysts found incidentally on CT or MRI

Como¹,

Valotto

Franco³

et al. 2021

BJR

Objectives: To investigate the impact of Contrast-enhanced ultrasound (CEUS) in reclassifying incidental renal findings categorized as indeterminate lesions (IL) or Bosniak ≥ 2F complex renal cysts (CRC) on Computed tomography (CT) or Magnetic resonance imaging (MRI). Methods: We retrospectively included forty-four subjects who underwent CEUS between 2016–2019 to assess 48 IL (n = 12) and CRC (n = 36) incidentally found on CT or MRI. CEUS was performed by one radiologist with 10 year of experience with a sulfur hexafluoride-filled microbubble contrast agent. The same radiologist, blinded to clinical information and previous CT/MRIs, retrospectively reviewed CEUS images/videos, categorizing renal findings with Bosniak-derived imaging categories ranging from 0 (indeterminate) to 5 (solid lesion). CEUS-related reclassification rate was calculated (proportion of IL reclassified with an imaging category >0, or CRC reclassified below or above imaging category >2F). Using histological examination or a ≥ 24 months follow-up as the standard of reference, we also estimated per-lesion sensitivity/specificity for malignancy. Results: CEUS reclassified 24/48 findings (50.0%; 95% C.I. 35.2–64.7), including 12/12 IL (100%; 95% CI 73.5–100) and 12/36 CRC (33.3%; 95% C.I. 18.5–50.9), mostly above category >2F (66.7%). CEUS and CT/MRI showed 96.0% (95%CI 79.7–99.9) versus 44.0% (95%CI 24.4–65.1) sensitivity, and 82.6% (95%CI 61.2–95.1) versus 60.9% (95%CI 38.5–80.3%) specificity. Conclusions: CEUS provided substantial and accurate reclassification of CT/MRI incidental findings. Advances in knowledge: Previous studies included Bosniak two incidental findings, thus possibly underestimating CEUS-induced reclassification rates. Using a more meaningful cut-off (Bosniak ≥2F), problem-solving CEUS was effective as well, with higher reclassification rates for CRC than in literature.