Progression, interobserver agreement, and malignancy rate in complex renal cysts (≥Bosniak category IIF)

El‐Mokadem, Ismail; Budak, Mathew; Pillai, Sanjay; Lang, Stephen; Doull, Robert; Goodman, Carol; Nabi, Ghulam

doi:10.1016/j.urolonc.2012.08.018

Cited by 64 publications

(54 citation statements)

References 20 publications

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“…During (ii) Referral Management System (RMS) which is a primary care system for a population of more than 400,000 individuals. Data linkage captured the doses, start date of ACEIs and name of medication (38,39). The incidence, severity and duration of all types of radiation induced proctitis were the primary study outcome.…”

Section: Methodsmentioning

confidence: 99%

Can Angiotensin-Converting Enzyme Inhibitors Reduce the Incidence, Severity, and Duration of Radiation Proctitis?

Alashkham

Paterson

Rauchhaus

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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Section: Methodsmentioning

confidence: 99%

Can Angiotensin-Converting Enzyme Inhibitors Reduce the Incidence, Severity, and Duration of Radiation Proctitis?

Alashkham

Paterson

Rauchhaus

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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“…They may also demonstrate contrast-enhanced septa (usually multiple) that are usually irregular, thickened, and/or calcified. A significant proportion of these cysts are thought to be malignant (mean of 54%; Table 2), 6,[11][12][13]15, with larger lesions being more likely to be malignant than smaller ones. 47,49 Bosniak category IV Category IV cysts may have similar characteristics to those classified as category III.…”

Section: Bosniak Category IIImentioning

confidence: 99%

“…They usually demonstrate wall thickening and/or gross and nodular thickened septa, but a solid contrast-enhancing component is also observed adjacent to the cyst wall or septa. 5,13,18,19,22,50 Lesions in this category should be considered malignant until proven otherwise (mean of 88%; Table 2). …”

Section: Bosniak Category IIImentioning

confidence: 99%

“…(Level of evidence: 3; Recommendation: B) Approximately 15% of these category IIF cysts will progress in complexity (to Bosniak category III or IV) over time. 7,13,20,21,36 Progression is more likely to occur within the first two years and rarely occurs after five years. 36 Unfortunately, a clear progression pattern is yet to be identified and as a result, there is no evidence-based time limit for followup imaging.…”

Section: Bosniak Category Iifmentioning

confidence: 99%

“…67 Given their relatively indolent nature, there is emerging evidence suggesting that these lesions (especially Bosniak classification III) can be safely managed by active surveillance. 6,12,13,29,31,32,35,38,41,48,59 Extrapolating from data on SRMs, Bhatt et al have suggested that Bosniak III and perhaps even Bosniak IV cysts with a solid component measuring less than 3 cm could be managed with initial surveillance. 67 Nevertheless, given the paucity of data, this management strategy should be reserved for well-informed patients and generally for patients at high surgical risk due to comorbidities or limited life expectancy.…”

Section: Bosniak Category IVmentioning

confidence: 99%

See 2 more Smart Citations

CUA guideline on the management of cystic renal lesions

Richard¹,

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Jewett³

et al. 2017

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Update on MRI of Cystic Renal Masses Including Bosniak Version 2019

Krishna

Schieda

Pedrosa

et al. 2020

Magnetic Resonance Imaging

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Incidental cystic renal masses are common, usually benign, and almost always indolent. Since 1986, the Bosniak classification has been used to express the risk of malignancy in a cystic renal mass detected at imaging. Historically, magnetic resonance imaging (MRI) was not included in that classification. The proposed Bosniak v.2019 update has formally incorporated MRI, included definitions of imaging terms designed to improve interobserver agreement and specificity for malignancy, and incorporated a variety of masses that were incompletely defined or not included in the original classification. For example, at unenhanced MRI, homogeneous masses markedly hyperintense at T2‐weighted imaging (similar to cerebrospinal fluid) and homogeneous masses markedly hyperintense at fat suppressed T1‐weighted imaging (approximately ≥2.5 times more intense than adjacent renal parenchyma) are classified as Bosniak II and may be safely ignored, even when they have not been imaged with a complete renal mass MRI protocol. MRI has specific advantages and is recommended to evaluate masses that at computed tomography (CT) 1) have abundant thick or nodular calcifications; 2) are homogeneous, hyperattenuating, ≥3 cm, and nonenhancing; or 3) are heterogeneous and nonenhancing. Although MRI is generally excellent for characterizing cystic renal masses, there are unique weaknesses of MRI that bear consideration. These details and others related to MRI of cystic renal masses are described in this review, with an emphasis on Bosniak v.2019. A website (https://bosniak-calculator.herokuapp.com/) and mobile phone apps named “Bosniak Calculator” have been developed for ease of assignment of Bosniak classes.Level of Evidence5Technical Efficacy Stage3

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Progression, interobserver agreement, and malignancy rate in complex renal cysts (≥Bosniak category IIF)

Cited by 64 publications

References 20 publications

Can Angiotensin-Converting Enzyme Inhibitors Reduce the Incidence, Severity, and Duration of Radiation Proctitis?

Can Angiotensin-Converting Enzyme Inhibitors Reduce the Incidence, Severity, and Duration of Radiation Proctitis?

CUA guideline on the management of cystic renal lesions

Update on MRI of Cystic Renal Masses Including Bosniak Version 2019

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