Contrast-enhanced voiding urosonography, a possible candidate for the diagnosis of vesicoureteral reflux in children and adolescents; a systematic review and meta-analysis

Yousefifard, Mahmoud; Toloui, Amirmohammad; Alavi, Seyedeh Niloufar Rafiei; Neishaboori, Arian Madani; Ahmadzadeh, Koohyar; Ghelichkhani, Parisa; Safari, Saeed; Abbasi, Arash; Ataei, Neamatollah; Hosseini, Mostafa

doi:10.1016/j.jpurol.2021.10.023

Cited by 9 publications

(4 citation statements)

References 52 publications

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“…In this regard, a recent systematic review and meta-analysis published by Yousefifard et al [ 48 ] confirmed the undeniable diagnostic role of CEUS for VUR detection in childhood. In particular, the AUC, sensitivity and specificity for VUR detection were 0.97 (95% CI: 0.95, 0.98), 0.92 (95% CI: 0.86, 0.96), and 0.94 (95% CI: 0.95, 0.98) for the 1st-generation contrast agents and 0.97 (95% CI: 0.95, 0.98), 0.93 (95% CI: 0.86, 0.97), and 0.91 (95% CI: 0.86, 0.95) for the 2nd-generation contrast agents, unequivocally proving the role of CEUS as a radiation-free alternative to voiding cystourethrogram (VCUG) for VUR diagnosis in children.…”

Section: Contrast-enhanced Ultrasound (Ceus)mentioning

confidence: 92%

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Fluorescence-Guided Surgery and Novel Innovative Technologies for Improved Visualization in Pediatric Urology

Paraboschi

Mantica

Minoli

et al. 2022

IJERPH

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Fluorescence-guided surgery (FGS), three-dimensional (3D) imaging technologies, and other innovative devices are rapidly revolutionizing the field of urology, providing surgeons with powerful tools for a more complete understanding of patient-specific anatomy. Today, several new intraoperative imaging technologies and cutting-edge devices are available in adult urology to assist surgeons in delivering personalized interventions. Their applications are also gradually growing in general pediatric surgery, where the detailed visualization of normal and pathological structures has the potential to significantly minimize perioperative complications and improve surgical outcomes. In the field of pediatric urology, FGS, 3D reconstructions and printing technologies, augmented reality (AR) devices, contrast-enhanced ultrasound (CEUS), and intraoperative magnetic resonance imaging (iMRI) have been increasingly adopted for a more realistic understanding of the normal and abnormal anatomy, providing a valuable insight to deliver customized treatments in real time. This narrative review aims to illustrate the main applications of these new technologies and imaging devices in the clinical setting of pediatric urology by selecting, with a strict methodology, the most promising articles published in the international scientific literature on this topic. The purpose is to favor early adoption and stimulate more research on this topic for the benefit of children.

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Section: Contrast-enhanced Ultrasound (Ceus)mentioning

confidence: 92%

“…Contrast-enhanced ultrasound (CEUS) is a dynamic imaging technique that has been increasingly employed in pediatric urology. It provides morphological and functional data of the urinary tract by administering an ultrasonographic contrast agent, either intravesically or intravenously ( Figure 1 d) [ 47 , 48 ].…”

Section: Contrast-enhanced Ultrasound (Ceus)mentioning

confidence: 99%

Fluorescence-Guided Surgery and Novel Innovative Technologies for Improved Visualization in Pediatric Urology

Paraboschi

Mantica

Minoli

et al. 2022

IJERPH

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“…The diagnostic sensitivity and specificity of ceVUS are superior to VCUG. A recent meta-analysis has clearly shown that ceVUS has a sensitivity of 93% and a specificity of 91% [26].…”

Section: The Diagnostic Methods For the Detection Of Vur And Its Clas...mentioning

confidence: 99%

The Intrarenal Reflux Diagnosed by Contrast-Enhanced Voiding Urosonography (ceVUS): A Reason for the Reclassification of Vesicoureteral Reflux and New Therapeutic Approach?

Saraga,

Saraga-Babić,

Arapović

et al. 2024

Biomedicines

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Vesicoureteral reflux (VUR) is defined as the urine backflow from the urinary bladder to the pyelo-caliceal system. In contrast, intrarenal reflux (IRR) is the backflow of urine from the renal calyces into the tubulointerstitial space. VURs, particularly those associated with IRR can result in reflux nephropathy when accompanied by urinary tract infection (UTI). The prevalence of IRR in patients with diagnosed VUR is 1–11% when using voiding cystourethrography (VCUG), while 11.9–61% when applying the contrast-enhanced voiding urosonography (ceVUS). The presence of IRR diagnosed by VCUG often correlates with parenchymal scars, when diagnosed by a 99mTc dimercaptosuccinic acid scan (DMSA scan), mostly in kidneys with high-grade VURs, and when diagnosed by ceVUS, it correlates with the wide spectrum of parenchymal changes on DMSA scan. The study performed by both ceVUS and DMSA scans showed IRRs associated with non-dilated VURs in 21% of all detected VURs. A significant difference regarding the existence of parenchymal damage was disclosed between the IRR-associated and IRR-non-associated VURs. A higher portion of parenchymal changes existed in the IRR-associated VURs, regardless of the VUR grade. That means that kidneys with IRR-associated VURs represent the high-risk group of VURs, which must be considered in the future classification of VURs. When using ceVUS, 62% of places where IRR was found were still unaffected by parenchymal changes. That was the basis for our recommendation of preventive use of long-term antibiotic prophylaxis until the IRR disappearance, regardless of the VUR grade. We propose a new classification of VURs using the ceVUS method, in which each VUR grade is subdivided based on the presence of an IRR.

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“…The intravenous applications of CEUS have been mainly applied to adults to differentiate renal lesions 10 , 14 – 16 . However, the most common pediatric CEUS use of the urethral is voiding CEUS examination with the intravesical ultrasound contrast agent injection to evaluate vesicoureteral reflux and urinary tract obstruction 17 , 18 . Some studies focus on the clinical use of renal intravenous CEUS in pediatric patients 19 – 21 .…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced ultrasound for differentiating benign from malignant focal solid renal lesions in pediatric patients

Fu,

Zhong,

Tan

et al. 2024

Sci Rep

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The contrast-enhanced ultrasound (CEUS) has been mainly applied to adults to differentiate benign and malignant renal lesions, however, the characteristics of CEUS in pediatric has not been as well studied as in adults. In the present work, the eligible pediatric patients who underwent renal CEUS between March 2016 and February 2023 were retrospectively analyzed. It included 20 lesions (median diameter, 8.4 cm; range, 1.8–18.0 cm) from 20 patients (median age, 28.0 months; range, 3.0–212.0 months; 9 boys) in malignant group and 5 lesions (median diameter, 3.8 cm; range, 1.3–7.5 cm) from 5 patients (median age, 25.0 months; range, 0.7–216.0 months; 2 boys) in benign group. The diagnostic performance was assessed. Nonparametric and Chi-square tests were performed. With hyperenhancement plus wash-out, CEUS showed a sensitivity of 95.0% [95% confidence interval (CI): 75.1%, 99.9%], a specificity of 80.0% (CI: 28.4%, 99.5%), a positive predictive value of 95.0% (CI: 75.1%, 99.9%) and a negative predictive value of 80.0% (CI: 28.4%, 99.5%). It suggested that CEUS is a valuable technique for identifying between malignant and benign renal lesions in children.

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Contrast-enhanced voiding urosonography, a possible candidate for the diagnosis of vesicoureteral reflux in children and adolescents; a systematic review and meta-analysis

Cited by 9 publications

References 52 publications

Fluorescence-Guided Surgery and Novel Innovative Technologies for Improved Visualization in Pediatric Urology

Fluorescence-Guided Surgery and Novel Innovative Technologies for Improved Visualization in Pediatric Urology

The Intrarenal Reflux Diagnosed by Contrast-Enhanced Voiding Urosonography (ceVUS): A Reason for the Reclassification of Vesicoureteral Reflux and New Therapeutic Approach?

Contrast-enhanced ultrasound for differentiating benign from malignant focal solid renal lesions in pediatric patients

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