The independent indicators for differentiating renal cell carcinoma from renal angiomyolipoma by contrast-enhanced ultrasound

Cao, Hongli; Fang, Liang; Chen, Lin; Zhan, Jia; Diao, Xinping; Liu, Yingchun; Chen, Lu; Zhang, Zhengwang; Chen, Yue

doi:10.1186/s12880-020-00436-9

Cited by 17 publications

(15 citation statements)

References 29 publications

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“…In addition, our previous study of 172 renal masses (150 RCCs and 22 AMLs) showed significant difference in PRE between RCCs and AMLs on CEUS (76.7% vs. 9.1%，P = .000). 14 Compared with the above studies, PRE presented at a higher rate (80.9%, 106/131) in this study, which may be due to the small size of the masses (≤4 cm). Previous study showed that the presence of mass pseudocapsule was related to the tumor size of RCCs, with a substantially higher prevalence in tumors of size 2.1-5 cm than in tumors of other sizes.…”

Section: Discussioncontrasting

confidence: 68%

“…In one of our previous studies, we found that hyperenhancement (64/81, 79.0%), homogeneous enhancement (54/81, 66.7%), fast wash out (WO) (63/81, 77.8%), and peripheral rim‐like enhancement (PRE) (45/81, 55.6%) were the typical characteristics of small RCC (≤3.0 cm) 8 . In a more recent study, we found that PRE and fast WO are important indicators for predicting RCC 14 . However, we did not consider the factors responsible for RCC subtypes in both studies and the size of renal mass in the second study.…”

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confidence: 92%

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The Value of Contrast‐Enhanced Ultrasound in Diagnosing Small Renal Cell Carcinoma Subtypes and Angiomyolipoma

Cao

Fang

Chen

et al. 2021

J of Ultrasound Medicine

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Objectives-To retrospectively explore the value of contrast-enhanced ultrasound (CEUS) in differentiating small renal cell carcinomas (RCCs) from angiomyolipomas (AMLs), and distinguishing between clear cell RCC (ccRCC), papillary RCC (pRCC), and chromophobe RCC (chRCC).Methods-A total of 151 patients with small renal masses (110 ccRCCs, 12 pRCCs, 9 chRCCs, and 20 AMLs) were enrolled between August 2016 and October 2019.Results-There were significant differences in terms of enhancement intensity (EI), enhancement homogeneity, perilesional rim-like enhancement (PRE), wash in, and wash out (WO) between RCC and AML (P = .000, .011, .000, .001, .000, respectively). Although there was no significant difference in EI between pRCC and chRCC (P = .272), EI of ccRCC was higher than that of pRCC (P = .000) and chRCC (P = .010). Multivariate regression analysis showed PRE and fast WO were related to RCC (OR = 18.189, 15.141, respectively). Although there were no significant differences in the sensitivity and area under the curve (AUC) between PRE and fast WO (95.0% vs. 95.0%, P = 1.000 and .880 vs. 0.799, P = .123, respectively), the specificity of PRE in predicting RCC was higher than that of fast WO (80.92% vs. 64.89%, P = .011). The sensitivity, specificity, and AUC of the two characteristics combination for differentiating RCC from AML were 95.0%, 90.8%, and 0.920, respectively, and that of EI for differentiating between ccRCC, pRCC, and chRCC were 81.0%, 78.2%, and 0.796, respectively.Conclusions-CEUS has value in differentiating small RCCs from AMLs and distinguishing ccRCC, a subtype associated with a greater likelihood of malignant behavior from pRCC and chRCC.

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Section: Discussioncontrasting

confidence: 68%

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confidence: 92%

The Value of Contrast‐Enhanced Ultrasound in Diagnosing Small Renal Cell Carcinoma Subtypes and Angiomyolipoma

Cao

Fang

Chen

et al. 2021

J of Ultrasound Medicine

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“…Or it can also be explained that when the tumor size exceeds 4 cm, it always invades the renal capsule and infiltrates into perirenal fat so the pseudocapsule is disrupted or even absent. 34 …”

Section: Discussionmentioning

confidence: 99%

Contrast‐enhanced ultrasound (CEUS) of benign and malignant renal tumors: Distinguishing CEUS features differ with tumor size

Zhu

Zhao

et al. 2022

Cancer Medicine

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Background Contrast‐enhanced ultrasound (CEUS) is now a guideline‐recommended strategy for diagnosing renal lesions. Tumor size is related to the risk of the treatment and prognosis in renal tumors. Thus, we aim to analyze the CEUS features of solid renal tumors in relation to tumor size. Methods The CEUS appearance of 156 pathologically diagnosed solid renal tumors were retrospectively analyzed. Three groups were stratified according to the tumor size (≤2 cm [group I], 2.1–4 cm [group II] and 4.1–7 cm [group III]). For each group, the features of wash‐in type, enhancement degree, enhancement homogeneity, and the presence of a pseudocapsule sign were compared between benign and malignant tumors. Results All 156 included lesions were detected by CEUS. The proportion of benign tumors in three size groups was 37.1%, 19.4%, and 20.4%, respectively. The proportion of malignant tumors was highest (80.6%) in group II, followed by group III (79.6%) and group I (62.9%). In group I, malignant and benign tumors differed significantly in the presence of a pseudocapsule sign ( p = 0.015) and homogeneity ( p = 0.007). In group II, the degree of enhancement differed ( p = 0.02) between tumor types. In group III, the two tumor types differed in both the wash‐in pattern ( p = 0.015) and enhancement degree ( p = 0.024). The weighted and Cohen's kappa values for the concordance between inter‐observer agreement ranged from 0.31 (95% CI: 0.36–0.57) to 0.90 (95% CI: 0.77–1.00). Conclusions CEUS features of malignant and benign renal tumors change along with the tumor size. The use of CEUS features in the diagnosis of benign and malignant tumors requires consideration of tumor size.

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“…Specifically, the presence of perilesional rim-like enhancement, commonly defined as pseudocapsule, results from tumor growth producing compression, ischemia, and necrosis of adjacent normal tissue, and consequent change in fibrous tissue. Notably, this sign was useful in discriminating malignancy among other historical series [ 18 , 19 ]. However, it should be taken into account that the presence of pseudocapsule could be inversely related to the tumor size of RCCs and is usually absent in hemorrhagic cysts and angiomyolipomas [ 20 , 21 , 22 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Contrast-Enhanced Ultrasound in the Evaluation of Small Renal Masses: A Systematic Review and Meta-Analysis

et al. 2022

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Ultrasound (US) is a highly sensitive imaging tool in the detection of renal masses. However, the detection rate of small renal masses (SRMs) (<4 cm) is still limited. In this scenario, contrast-enhanced ultrasound (CEUS) is a relatively novel, but increasingly utilized, diagnostic modality which aims to increase the overall diagnostic ability in the identification of SRMs. In consequence, we performed a systematic review (SR) and pooled meta-analysis to investigate the diagnostic performance of CEUS in the evaluation of SRMs confirmed by pathology. A SR up to April 2022 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The diagnostic performance of CEUS was evaluated basing on malignant vs. benign SMRs. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) from eligible studies were pooled, and summary receiver operating characteristic (SROC) curves were constructed for each endpoint. Overall, five qualified studies were deemed suitable for this meta-analysis. Finally, diagnostic performance of CEUS showed an accuracy of 0.93 in detecting malignant masses (sensitivity of 0.94, PPV of 0.95, specificity of 0.78, and NPV of 0.73). Taken together, CEUS may represent a promising minimally invasive diagnostic tool for characterization of SMRs, since it allows clinicians to identify malignant lesions.

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The independent indicators for differentiating renal cell carcinoma from renal angiomyolipoma by contrast-enhanced ultrasound

Cited by 17 publications

References 29 publications

The Value of Contrast‐Enhanced Ultrasound in Diagnosing Small Renal Cell Carcinoma Subtypes and Angiomyolipoma

The Value of Contrast‐Enhanced Ultrasound in Diagnosing Small Renal Cell Carcinoma Subtypes and Angiomyolipoma

Contrast‐enhanced ultrasound (CEUS) of benign and malignant renal tumors: Distinguishing CEUS features differ with tumor size

Diagnostic Performance of Contrast-Enhanced Ultrasound in the Evaluation of Small Renal Masses: A Systematic Review and Meta-Analysis

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