Contrast-enhanced Ultrasound (CEUS) vs contrast-enhanced computed tomography for multilocular cystic renal neoplasm of low malignant potential

Abstract

Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) might be benefited from nephron-sparing surgery. Contrast-enhanced computed tomography is used for the diagnosis of MCRNLMP but contrast-enhanced ultrasound has lack of nephrotoxicity and several advantages over contrast-enhanced computed tomography and contrast-enhanced magnetic resonance. The purpose of the study was to compare diagnostic parameters of preoperative contrast-enhanced ultrasound against contrast-enhanced computed tomography for the detection of MCRNLMP in patients who faced curative surgery for complex cystic renal mass. Data regarding contrast-enhanced ultrasound, contrast-enhanced computed tomography, and clinicopathological results of 219 patients who underwent curative surgery for complex cystic renal mass (Bosniak classification III or IV) were retrospectively collected and analyzed. Bosniak classification for imaging modality and the 2016 WHO criteria for clinic pathology were used for detection of MCRNLMP. Contrast-enhanced ultrasound, contrast-enhanced computed tomography, and clinicopathology were detected 68, 66, and 67 as a MCRNLMP respectively. Contrast-enhanced ultrasound and contrast-enhanced computed tomography had 30.37% and 29.27% sensitivities for the detection of MCRNLMP. While 60% and 50% specificities respectively. Bosniak classification III ( P = .045) and lower mean Hounsfield unit ( P = .049) were associated with the prevalence of MCRNLMP. Contrast-enhanced computed tomography was detected 6 and 7, while contrast-enhanced ultrasound detected 3 and 2 complex cystic renal mass as false positive and false negative MCRNLMP respectively. A contrast-enhanced ultrasound had 0.011 to 1.0 diagnostic confidence and contrast-enhanced computed tomography had 0.045 to 0.983 diagnostic confidence for decision making of nephron-sparing surgeries. Contrast-enhanced ultrasound may have better visualization of MCRNLMP than contrast-enhanced computed tomography. Level of Evidence: III.

Ultrasound-based “CEUS-Bosniak”classification for cystic renal lesions: an 8-year clinical experience

“…However, the distinction of predominantly cystic RCC from MCRNLMP remains a notorious challenge for imaging techniques. [ 25 , 26 ] In our study, MCRNLMP ( n = 7) was assigned to CEUS-Bosniak-III (3/7), and CEUS-Bosniak-IV (4/7) and to CT/MRI-Bosniak-IIF (1/7), and CT/MRI-Bosniak-III (6/7). In summary, one should not try to equalize Bosniak categories, despite morphological overlap.…”

The Diagnostic Impact of Contrast-Enhanced Computed Tomography (CECT) in Evaluating Lymph Node Involvement in Colorectal Cancer: A Comprehensive Review

“…CEUS has demonstrated excellent sensitivity and negative predictive value, emerging as a promising screening tool for renal cystic lesions [ 44 ]. Moreover, CEUS proves advantageous in complex cystic renal mass surgeries, assisting in decision-making for curative surgeries and reducing the risk of unnecessary radical nephrectomy [ 45 ]. However, the efficacy of CEUS heavily relies on the skills of the performing physician, and there may be limitations concerning interrater reliability among readers and potential misdiagnosis of specific renal lesions [ 45 ].…”

“…Moreover, CEUS proves advantageous in complex cystic renal mass surgeries, assisting in decision-making for curative surgeries and reducing the risk of unnecessary radical nephrectomy [ 45 ]. However, the efficacy of CEUS heavily relies on the skills of the performing physician, and there may be limitations concerning interrater reliability among readers and potential misdiagnosis of specific renal lesions [ 45 ]. While CECT offers immediate image availability and the ability to assess extra-hepatic tissues, it carries the drawbacks of ionizing radiation exposure and potential adverse effects from contrast agents.…”