Contrast-enhanced ultrasound for differentiating benign from malignant solid small renal masses: comparison with contrast-enhanced CT

Wei, Shuping; Xu, C.; Zhang, Qing; Zhang, Qirui; Zhao, Yanping; Huang, Pengfei; Xie, Yingdong; Zhou, Changsheng; Tian, Fei; Yang, Bin

doi:10.1007/s00261-017-1111-x

Cited by 47 publications

(31 citation statements)

References 32 publications

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“…In the present study, primarily oncocytomas and angiomyolipomas were misinterpreted, which may be consistent with other studies that show similar difficulties in differentiating these entities due to similar imaging characteristics [29][30][31][32][33][34][35][36]. The literature describes how the additive performance of shear wave elastography with ARFI (acoustic radiation force impulse) can be used to obtain better differentiation between clear cell renal cell carcinomas and oncocytomas.…”

Section: Discussionsupporting

confidence: 90%

Comparison of computed tomography (CT), magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in the evaluation of unclear renal lesions

Marschner

Ruebenthaler

Schwarze

et al. 2020

Rofo

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Purpose To compare the sensitivity and specificity of contrast-enhanced ultrasound (CEUS), computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of unclear renal lesions to the histopathological outcome. Materials and methods A total of 255 patients with a single unclear renal mass with initial imaging studies between 2005 and 2015 were included. Patient ages ranged from 18 to 86 with (mean age 62 years; SD ± 13). CEUS (255 patients), CT (88 out of 255 patients; 34.5 %) and MRI (36 out of 255 patients; 14.1 %) were used for determining malignancy or benignancy and initial findings were correlated with the histopathological outcome. Results CEUS showed a sensitivity of 99.1 % (95 % confidence interval (CI): 96.7 %, 99.9 %), a specificity of 80.5 % (95 % CI: 65.1 %, 91.2 %), a positive predictive value (PPV) of 96.4 % (95 % CI: 93.0 %, 98.4 %) and a negative predictive value (NPV) of 94.3 % (95 % CI: 80.8 %, 99.3 %). CT showed a sensitivity of 97.1 % (95 % CI: 89.9 %, 99.6 %), a specificity of 47.4 % (95 % CI: 24.4 %, 71.1 %), a PPV of 87.0 % (95 % CI: 77.4 %, 93.6 %) and a NPV of 81.8 % (95 % CI: 48.2 %, 97.7 %). MRI showed a sensitivity of 96.4 % (95 % CI: 81.7 %, 99.9 %), a specificity of 75.0 % (95 % CI: 34.9 %, 96.8 %), a PPV of 93.1 % (95 % CI: 77.2 %, 99.2 %) and a NPV of 85.7 % (95 % CI: 42.1 %, 99.6 %). Out of the 212 malignant lesions a total of 130 clear cell renal carcinomas, 59 papillary renal cell carcinomas, 7 chromophobe renal cell carcinomas, 4 combined clear cell and papillary renal cell carcinomas and 12 other malignant lesions, e. g. metastases, were diagnosed. Out of the 43 benign lesions a total 10 angiomyolipomas, 3 oncocytomas, 8 benign renal cysts and 22 other benign lesions, e. g. renal adenomas were diagnosed. Using CEUS, 10 lesions were falsely identified as malignant or benign, whereas 8 lesions were false positive and 2 lesions false negative. Conclusion CEUS is an useful method which can be additionally used to clinically differentiate between malignant and benign renal lesions. CEUS shows a comparable sensitivity, specificity, PPV and NPV to CT and MRI. In daily clinical routine, patients with contraindications for other imaging modalities can particularly benefit using this method. Key Points: Citation Format

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Section: Discussionsupporting

confidence: 90%

Comparison of computed tomography (CT), magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in the evaluation of unclear renal lesions

Marschner

Ruebenthaler

Schwarze

et al. 2020

Rofo

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“…Advanced ultrasound techniques such as contrastenhancement using an intravenous injection of microbubbles may prove useful for characterisation of suspected renal masses. Contrast-enhanced ultrasound has been used in the UK in adults for more than a decade and is described for distinguishing malignant renal tumours from pseudotumours in adults [54][55][56] . The main advantage is that one can perform…”

Section: Ultrasoundmentioning

confidence: 99%

The role of imaging in the initial investigation of paediatric renal tumours

Watson

Oostveen

Rogers

et al. 2020

The Lancet Child & Adolescent Health

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Imaging plays a key role in the assessment of paediatric renal tumours, especially where the initial treatment approach is to proceed to standardised chemotherapy without histological confirmation. In Europe according to the SIOP guidelines, core needle biopsy is not routinely performed unless the child is older than 10 years. Between 6 months and 9 years, the child is treated with a standard regimen of pre-operative chemotherapy unless there concerns for non-Wilms tumour pathology. Atypical imaging findings may therefore stratify a child into a different treatment protocol and may prompt the need for pre-treatment histology. This review details the latest protocols and techniques used in the assessment of paediatric renal tumours. Important imaging findings are considered especially those features which might prompt the need for a pre-treatment biopsy. Local radiology practices vary, both MRI and CT are widely used as a routine imaging test for the assessment of paediatric renal tumours in Europe. Advances in imaging technology and MRI sequences are facilitating the development of new techniques which may increase the utility of imaging in terms of predicting tumour histology and clinical behaviour. Several of these techniques are considered here. Key points 1. Routine core needle biopsy of a renal mass is no longer recommended by UK and European guidelines for children between 6 months and 10 years with typical clinical and radiological features of a Wilms tumour 2. Ultrasound should be the first imaging modality for investigation of any suspected abdominal mass in a child 3. MRI or CT can be used interchangeably for the assessment of a known renal mass. MRI is recommended in the latest UMBRELLA research trial. 4. It is important to know the imaging features of a renal mass which suggest a non-Wilms tumour 5. Imaging cannot yet differentiate different tumour types or Wilms tumour stage but there are interesting areas of imaging research which may advance this area of imaging in the future

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“…Six of the 16 included studies were cohort studies [17][18][19][20][21][22] and 10 were descriptive studies [23][24][25][26][27][28][29][30][31][32]; none were RCTs ( Table 1).…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

Comparison of the Diagnostic Performance of Contrast-enhanced Ultrasound with That of Contrast-enhanced Computed Tomography and Contrast-enhanced Magnetic Resonance Imaging in the Evaluation of Renal Masses: A Systematic Review and Meta-analysis

Furrer

Spycher

Büttiker

et al. 2020

European Urology Oncology

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Contrast-enhanced ultrasound for differentiating benign from malignant solid small renal masses: comparison with contrast-enhanced CT

Abstract: Both CEUS and CECT imaging modalities are effective for the differential diagnosis of benign and malignant SRMs. Furthermore, CEUS may be more effective than CECT for the qualitative diagnosis of small papillary RCC.

Cited by 47 publications

References 32 publications

Comparison of computed tomography (CT), magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in the evaluation of unclear renal lesions

Comparison of computed tomography (CT), magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in the evaluation of unclear renal lesions

The role of imaging in the initial investigation of paediatric renal tumours

Comparison of the Diagnostic Performance of Contrast-enhanced Ultrasound with That of Contrast-enhanced Computed Tomography and Contrast-enhanced Magnetic Resonance Imaging in the Evaluation of Renal Masses: A Systematic Review and Meta-analysis

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