How I Do It: Evaluating Renal Masses

Israel, Gary M.; Bosniak, Morton A.

doi:10.1148/radiol.2362040218

Cited by 423 publications

(290 citation statements)

References 55 publications

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“…RMs can be classified as solid or cystic on the basis of the imaging findings. For solid RMs, the most important criterion for differentiating malignant lesions is the presence of contrast enhancement or restriction on MRI (LE 3) [17]. Most RMs can be diagnosed accurately using imaging alone.…”

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

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“…They usually demonstrate wall thickening and/or gross and nodular thickened septa, but a solid contrast-enhancing component is also observed adjacent to the cyst wall or septa. 5,13,18,19,22,50 Lesions in this category should be considered malignant until proven otherwise (mean of 88%; Table 2). …”

Section: Bosniak Category IIImentioning

confidence: 99%

CUA guideline on the management of cystic renal lesions

Richard¹,

Violette²,

Jewett³

et al. 2017

CUAJ

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“…Alongside the cyst's diameter, wall thickness, presence of septa and contrast enhancing components, the measurement of the mean CT attenuation value (in Hounsfield Units, HU) of the cysts' content on unenhanced CT images as well as the assessment of its attenuation pattern after the administration of intravenous contrast media are supporting the radiologists to classify cystic renal lesions [2]. Cysts surrounded by thin, smooth walls and mean CT attenuation values between 0 -20 HU are considered simple benign cysts if they do not enhance after the application of contrast agents [2][3][4]. These cysts are classified category I by Bosniak [1].…”

Section: Introductionmentioning

confidence: 99%

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

et al. 2010

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PURPOSE: To differentiate proxy renal cystic lesions containing protein, blood, iodine contrast or saline solutions using dual-energy CT (DECT) equipped with a new tin filter technology (TFT). MATERIALS AND METHODS: 70 proxies (saline, protein, blood and contrast agent) were placed in unenhanced and contrast-enhanced kidney phantoms. DECT was performed at 80/140 kV with and without tin filtering. Two readers measured the CT attenuation values in all proxies twice. An 80/140 kV ratio was calculated. RESULTS: All intra-and interobserver agreements were excellent (r = 0.93-0.97; p < 0.001). All CT attenuation values were significantly higher in the enhanced than in the unenhanced setting (p < 0.05; average increase, 12.5 +/-3.6HU), while the ratios remained similar (each, p > 0.05). The CT attenuation of protein, blood and contrast agent solution differed significantly with tin filtering (p < 0.01-0.05). Significant differences were found between the ratios of protein and blood compared to contrast medium solution (each, p < 0.05) and between the ratios of protein and blood in both phantoms with tin filtering (each, p < 0.05). CONCLUSION: DECT allows discrimination between a proxy renal lesion containing contrast agent and lesions containing protein and blood through their different attenuation at 80 kV and 140 kV. Further discrimination between protein and blood containing proxies is possible when using a tin filter.Dual-Energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study 1 Abstract Purpose: To differentiate proxy renal cystic lesions containing protein, blood, iodine contrast or saline solutions using dual-energy CT (DECT) equipped with a new tin filter technology (TFT). Materials and Methods:70 proxies (saline, protein, blood and contrast agent) were placed in unenhanced and contrast-enhanced kidney phantoms. DECT was performed at 80/140kV with and without tin filtering. Two readers measured the CT attenuation values in all proxies twice. An 80/140kV ratio was calculated.Results: All intra-and interobserver agreements were excellent (r=0.93-0.97; p<0.001). All CT attenuation values were significantly higher in the enhanced than in the unenhanced setting (p<0.05; average increase, 12.5±3.6HU), while the ratios remained similar (each, p>0.05). The CT attenuation of protein, blood and contrast agent solution differed significantly with tin filtering (p<0.01-0.05). Significant differences were found between the ratios of protein and blood compared to contrast medium solution (each, p<0.05) and between the ratios of protein and blood in both phantoms with tin filtering (each, p<0.05). Conclusion:DECT allows discrimination between a proxy renal lesion containing contrast agent and lesions containing protein and blood through their different attenuation at 80kV and 140kV. Further discrimination between protein and blood containing proxies is possible when using a tin filter.

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How I Do It: Evaluating Renal Masses

Cited by 423 publications

References 55 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

Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study

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