Bosniak Category IIF and III Cystic Renal Lesions: Outcomes and Associations

Smith, Andrew D.; Remer, Erick M.; Cox, Kelly; Lieber, Michael L.; Allen, Brian C.; Shah, Shetal N.; Herts, Brian R.

doi:10.1148/radiol.11110888

Cited by 141 publications

(85 citation statements)

References 19 publications

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“…Bosniak classification can predict the risk of malignancy (LE 3) and provide guidance for management [25]. Bosniak 1, 2, 2F, 3, and 4 cysts are malignant in 0%, 0%, 25%, 54%, and 100% of cases, respectively [26].…”

Section: Imagingmentioning

confidence: 99%

EAU Guidelines on Renal Cell Carcinoma: 2014 Update

Ljungberg¹,

Bensalah²,

Canfield³

et al. 2015

European Urology

2,677

1,914

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Context: The European Association of Urology Guideline Panel for Renal Cell Carcinoma (RCC) has prepared evidence-based guidelines and recommendations for RCC management. Objectives: To provide an update of the 2010 RCC guideline based on a standardised methodology that is robust, transparent, reproducible, and reliable. Evidence acquisition: For the 2014 update, the panel prioritised the following topics: percutaneous biopsy of renal masses, treatment of localised RCC (including surgical and nonsurgical management), lymph node dissection, management of venous thrombus, systemic therapy, and local treatment of metastases, for which evidence synthesis was undertaken based on systematic reviews adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Relevant databases (Medline, Cochrane Library, trial registries, conference proceedings) were searched (January 2000 to November 2013) including randomised controlled trials (RCTs) and retrospective or controlled studies with a comparator arm. Risk of bias (RoB) assessment and qualitative and quantitative synthesis of the evidence were performed. The remaining sections of the document were updated following a structured literature assessment. Evidence synthesis: All chapters of the RCC guideline were updated. For the various systematic reviews, the search identified a total of 10 862 articles. A total of 151 studies reporting on 78 792 patients were eligible for inclusion; where applicable, data from RCTs were included and meta-analyses were performed. For RCTs, there was low RoB across studies; however, clinical and methodological heterogeneity prevented data pooling for most studies. The majority of studies included were retrospective with matched or unmatched cohorts based on single or multi-institutional data or national registries. The exception was for systemic treatment of metastatic RCC, in which several RCTs have been performed, resulting in recommendations based on higher levels of evidence.

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Section: Imagingmentioning

confidence: 99%

EAU Guidelines on Renal Cell Carcinoma: 2014 Update

Ljungberg¹,

Bensalah²,

Canfield³

et al. 2015

European Urology

2,677

1,914

View full text Add to dashboard Cite

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“…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%

CUA guideline on the management of cystic renal lesions

Richard¹,

Violette²,

Jewett³

et al. 2017

CUAJ

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“…It is reported that Bosniak I, II, IIF, III, and IV cysts were malignant in 0, 0, 25, 54, and 100% of cases, respectively [26] . Due to the low probability of Bosniak I and II cysts being malignant, surgery is deemed unnecessary.…”

Section: Discussionmentioning

confidence: 98%

Does Computed Tomography Still Have Limitations to Distinguish Benign from Malignant Renal Tumors for Radiologists?

Shin¹,

Duddalwar

Ukimura³

et al. 2017

Urol Int

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Objectives: To evaluate the current accuracy of CT for diagnosing benign renal tumors. Materials and Methods: We retrospectively reviewed 905 patients who underwent preoperative CT followed by surgical resection. The final pathology was benign in 156 patients (17%). After exclusions, 140 patients with 163 benign tumors were included and 3 sets of the CT interpretations by radiologists with varying levels of experience were analyzed. Results: The histological breakdown was as follows: oncocytomas (54.6%), angiomyolipomas (AMLs; 30.7%), renal cysts (8.0%), other miscellaneous benign tumors (6.7%). The sensitivities of diagnosing oncocytomas were 3.4, 9.0, and 13.5% in primary radiological reports, second blinded reviews, and third non-blinded reviews, respectively (p = 0.055). The sensitivities of diagnosing AMLs were 46.0, 58.0, and 62.0% in the 3-sets of CT interpretations, respectively (p = 0.246). As for renal cysts, the sensitivities were 69.2, 92.3, and 100% in the 3-sets of CT interpretations, respectively (p = 0.051). In primary reports, the positive predictive values were 95.8% in lipid poor (lp)-AMLs, 60.0% in oncocytomas, 69.2% in renal cysts, respectively (p < 0.05). Conclusions: Current conventional CT imaging still has limitations in differentiating oncocytomas and lp-AMLs from renal cell carcinomas, even when images were re-examined by experienced radiologists.

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Bosniak Category IIF and III Cystic Renal Lesions: Outcomes and Associations

Cited by 141 publications

References 19 publications

EAU Guidelines on Renal Cell Carcinoma: 2014 Update

EAU Guidelines on Renal Cell Carcinoma: 2014 Update

CUA guideline on the management of cystic renal lesions

Does Computed Tomography Still Have Limitations to Distinguish Benign from Malignant Renal Tumors for Radiologists?

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