Prospective comparison of use of contrast-enhanced ultrasound and contrast-enhanced computed tomography in the Bosniak classification of complex renal cysts

Ragel, Matthew; Nedumaran, Anbu; Makowska-Webb, Jolanta

doi:10.1177/1742271x15626959

Cited by 16 publications

(18 citation statements)

References 32 publications

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“…CEUS may also be used to better delineate the septa number, septa and/or wall thickness, solid component, and the enhancement. 8,10,60 Ultrasound in combination with CT …”

Section: Bosniak Category Iifmentioning

confidence: 99%

CUA guideline on the management of cystic renal lesions

Richard¹,

Violette²,

Jewett³

et al. 2017

CUAJ

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“…CEUS may also be used to better delineate the septa number, septa and/or wall thickness, solid component, and the enhancement. 8,10,60 Ultrasound in combination with CT …”

Section: Bosniak Category Iifmentioning

confidence: 99%

CUA guideline on the management of cystic renal lesions

Richard¹,

Violette²,

Jewett³

et al. 2017

CUAJ

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“…In the near future, the Bosniak classification may be used not only in computed tomography, but also in other modalities, such as contrast-enhanced ultrasound or magnetic resonance imaging. However, previous studies [ 18 – 22 ] show controversial results and further research is required in order to prove the advantages of these methods.…”

Section: Discussionmentioning

confidence: 99%

Bosniak category III renal lesions: likelihood of malignancy based on computed tomography findings

Bielskienė

Augustinavičius

Valančienė

et al. 2018

CEJU

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IntroductionBosniak introduced a classification of renal cysts based on imaging characteristics. Cystic renal changes are categorized determining their risk of malignancy and further management. However, defining the malignancy of category III lesions still remains a challenge and our aim was to evaluate the features of malignancy in computed tomography within this category.Material and methodsThe Vilnius University Hospital Santariškių Klinikos information system was retrospectively searched for computed tomography examinations in which Bosniak category III lesions were reported. Data of genetic disorders and history of malignancy were collected. Longest diameter, location, shape, amount and location of calcification, contrast enhancement of Bosniak category III lesions were evaluated. The relation between collected data and malignancy was estimated.RESULTSThere were 73 patients with Bosniak category III lesions included and 43 cysts were surgically removed and histologically analyzed. Mean tumor size was significantly lower in malignant lesions. Mean enhancement in arterial and portovenous phase, change of mean enhancement in portovenous and native phases were significantly different between benign and malignant lesions. Significant differences in the contrast enhancement pattern was found: septa and capsular enhancement was detected in 28.6% (n = 12) of cases in malignant lesions, while only 4.8% (n = 2) benign lesions show the same enhancement pattern. Some other features showed tendencies to be more prevalent in malignant lesions, however, no significant differences were found.ConclusionsThe collected data and selected features do not allow us to reliably differentiate Bosniak category III cystic lesions as benign or malignant. Some of the criteria showed some tendencies, however, further studies are required to confirm these findings' potential.

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“…Power analysis was performed to determine optimal sample size. Based on a similar study, with type I error rate set to 0.05, odds ratio 0.25 and a statistical power of 0.8, at least 46 cysts were required [10].…”

Section: Patient Cohortmentioning

confidence: 99%

“…Ragel et al found that CEUS allowed for adequate follow-up of complex renal lesions without the drawbacks of CECT (which comes at a higher cost, with ionising radiation and nephrotoxicity of contrast agents). However, the authors also acknowledged the challenge of operator dependence in CEUS [10]. Furthermore, the role of ultrasound (and consequently CEUS) has yet to be fully established [8].…”

Section: Introductionmentioning

confidence: 99%

Bosniak classification of cystic renal masses: utility of contrastenhanced ultrasound using version 2019

et al. 2020

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Aim: To compare the latest 2019 version of Bosniak classification (BCnew) against Bosniak classification prior to 2019 (BCold) using contrast-enhanced ultrasound (CEUS) and to compare CEUS against contrast-enhanced CT (CECT) based on BCnew.Material and methods: Patients who had both CEUS and CECT of the kidneys performed within three months of each other were included. CECT and CEUS images of renal cysts were retrospectively analysed by two independent readers using BCnew, extrapolating the BCnew criteria to CEUS. Where histopathology was not available, 3-year imaging follow-up was used as a reference standard.Results: Forty-nine patients with a total of 54 cysts were included. Using BCnew, Bosniak category between CEUS and CECT and both readers was concordant in 18 cysts (33.3%). Bosniak category between CEUS and CT was concordant in 27 cysts (50%) in reader 1 and in 33 cysts (61%) for reader 2. Based on Cohen’s weighted kappa statistic (k), inter-observer agreement was moderate for CEUS (k=0.49) and fair for CECT (k=0.36). Agreement between CEUS and CECT for both readers was fair (reader 1, k=0.24; reader 2, k=0.37). Compared to using BCold, almost half of the benign cysts were assigned to a lower Bosniak category with CEUS using BCnew (reader 1, 42.6%; reader 2, 50%).Conclusions: CEUS assessment based on BCnew more appropriately assigns benign renal cysts to a lower category than CEUS based on BCold. Readers tend to grade renal cysts to a higher Bosniak category with BCnew but with greater inter-reader agreement on CEUS than on CECT

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Prospective comparison of use of contrast-enhanced ultrasound and contrast-enhanced computed tomography in the Bosniak classification of complex renal cysts

Cited by 16 publications

References 32 publications

CUA guideline on the management of cystic renal lesions

CUA guideline on the management of cystic renal lesions

Bosniak category III renal lesions: likelihood of malignancy based on computed tomography findings

Bosniak classification of cystic renal masses: utility of contrastenhanced ultrasound using version 2019

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