Contrast-Enhanced Ultrasonography with Quantitative Analysis allows Differentiation of Renal Tumor Histotypes

Abstract

Totally 85 patients with 93 renal lesions who underwent contrast-enhanced ultrasound (CEUS) were retrospectively studied with quantitative analysis to evaluate its value in the differential diagnosis of renal tumor histotypes. CEUS characteristics were analysed including the enhancement patterns, peak intensity, homogeneity of enhancement, and pseudocapsule. Quantitative parameters of peak intensity (P) and time to peak (TP) were measured with QontraXt software, and the index “relative enhancement percentage” ΔP% and “difference in TP between tumor and cortex” ΔTP were used to quantify the CEUS features of renal tumors. There are significant difference in CEUS features between the 46 clear cell renal cell carcinoma (CCRCC) and other types of renal tumors, including 17 low malignant lesions, 11 urothelial carcinoma of the renal pelvis, and 19 renal angiomyolipoma. The differences lie in the peak intensity, the homogeneity, the time of wash-in, peak, clearance and presence of pseudocapsule. The ΔTP and ΔP% of the CCRCC is significantly different from other tumors. With “fast to peak + high peak intensity” as the main criterion, assisted with “heterogeneous enhancement” and “fast wash-in” as the secondary criteria, the diagnostic accuracy of CCRCC is 91.4%, demonstrating quantitative CEUS imaging is highly valuable in differentiating CCRCC from other tumors.

Effect of iodinated contrast media on renal perfusion: A randomized comparison study in pigs using quantitative contrast-enhanced ultrasound (CEUS)

“…A computerised offline analysis was performed with perfusion software (Qontrast ® , Bracco Imaging, Milano, Italy) by the principal investigator who conducted all examinations. A full-map parametric analysis of perfusion within a selected set of frames in a specific ROI 20 , 36 can be performed. The loop of images is automatically processed after the tissue region and perfusion period have been defined; translational movements of the selected area can also be corrected.…”

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

“…This may be related to the proportion of RCC subtypes included in this study. Sun et al [25] reported that 26%(5/19) of AMLs exhibited fast wash out, while, 74% lesions were confirmed by two enhanced imaging examinations including CEUS and CT/MRI. In our study, all the lesions were diagnosed via surgical pathology and only 4.5% (1/22) of AMLs exhibited fast wash out.…”

The independent indicators of contrast-enhanced ultrasound for predicting renal cell carcinoma

“…Sun et al [25] reported that 26%(5/19) of AMLs were fast wash out, while, 74% lesions were confirmed by two enhanced imaging examinations including CEUS and CT/MRI. In our study, all the lesions were diagnosed via surgical pathology and only 4.5% (1/22) of AMLs were fast wash out.…”