Single-center study: the diagnostic performance of contrast-enhanced ultrasound (CEUS) for assessing renal oncocytoma

Schwarze, Vincent; Marschner, Constantin; Figueiredo, Giovanna Negrão de; Knösel, Thomas; Rübenthaler, Johannes; Clevert, D.‐A.

doi:10.1080/21681805.2020.1736621

Cited by 17 publications

(16 citation statements)

References 29 publications

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“…Benign renal oncocytoma was found in 2/5 (20%) as Bosniak 3 categorized lesions. The latter finding is compatible with a recent retrospective study that could not describe a distinct sonomorphological appearance specific for renal oncocytoma [ 46 ]. Of those patients with Bosniak 4 lesions, which were categorized as such by fusion imaging, 10/12 (83%) were histopathologically scrutinized after (partial) nephrectomy.…”

Section: Discussionsupporting

confidence: 92%

“…Most of the incidental renal lesions are uncomplicated renal cysts [ 45 ]. Still, a relevant cohort of renal lesions remains indeterminate, among others, because of the overlapping morphologies of benign and malignant tumor entities [ 46 ]. Hence, further diagnostic assessment, biopsy, surgical (partial) resection, and histopathological analysis are of pivotal importance.…”

Section: Discussionmentioning

confidence: 99%

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Advanced Fusion Imaging and Contrast-Enhanced Imaging (CT/MRI–CEUS) in Oncology

Schwarze

Rübenthaler

Marschner

et al. 2020

Cancers

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Fusion imaging depicts an innovative technique that facilitates combining assets and reducing restrictions of advanced ultrasound and cross-sectional imaging. The purpose of the present retrospective study was to evaluate the role of fusion imaging for assessing hepatic and renal lesions. Between 02/2011–08/2020, 92 patients in total were included in the study, of which 32 patients had hepatic lesions, 60 patients had renal lesions. Fusion imaging was technically successful in all patients. No adverse side effects upon intravenous (i.v.) application of SonoVue® (Bracco, Milan, Italy) were registered. Fusion imaging could clarify all 11 (100%) initially as indeterminate described hepatic lesions by computed tomography/magnetic resonance imaging (CT/MRI). Moreover, 5/14 (36%) initially suspicious hepatic lesions could be validated by fusion imaging, whereas in 8/14 (57%), malignant morphology was disproved. Moreover, fusion imaging allowed for the clarification of 29/30 (97%) renal lesions initially characterized as suspicious by CT/MRI, of which 19/30 (63%) underwent renal surgery, histopathology revealed malignancy in 16/19 (84%), and benignity in 3/19 (16%). Indeterminate findings could be elucidated by fusion imaging in 20/20 (100%) renal lesions. Its accessibility and repeatability, even during pregnancy and in childhood, its cost-effectiveness, and its excellent safety profile, make fusion imaging a promising instrument for the thorough evaluation of hepatic and renal lesions in the future.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Advanced Fusion Imaging and Contrast-Enhanced Imaging (CT/MRI–CEUS) in Oncology

Schwarze

Rübenthaler

Marschner

et al. 2020

Cancers

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“…Nevertheless, several studies described that CEUS like any other imaging modality is unfeasible to safely distinguish between RCC subtypes solely relying on qualitative imaging features. Due to overlapping morphologic features, some benign entities, benign complicated cysts or oncocytoma, may even be misinterpreted as malignant lesions by diagnostic imaging [25]. Although contrast enhancement is a typical feature of malignant lesions, 10/29 Bosniak III renal lesions which featured contrast enhancement, revealed to be benign by histopathology in our study.…”

Section: Discussionmentioning

confidence: 58%

Contrast-Enhanced Ultrasound (CEUS) for the Evaluation of Bosniak III Complex Renal Cystic Lesions—A 10-Year Specialized European Single-Center Experience with Histopathological Validation

et al. 2020

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Background and objectives: The aim of the present retrospective single-center study is to evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) for assessing Bosniak III complex renal cystic lesions with histopathological validation. Materials and Methods: 49 patients with CEUS-categorized Bosniak III renal cystic lesions were included in this retrospective study. All patients underwent native B-mode, Color Doppler, contrast-enhanced ultrasound (CEUS) between 2010–2020. Eight and five patients underwent computed tomography (CT) and magnetic resonance imaging (MRI), respectively. Twenty-nine underwent (partial) nephrectomy allowing for histopathological analysis. The applied contrast agent for CEUS was a second-generation blood pool agent. Ultrasonography examinations were performed and interpreted by a single experienced radiologist with more than 15 years of experience (EFSUMB Level 3). Results: CEUS examinations were successfully performed in all included patients without registering any adverse effects. The malignancy rate of CEUS-categorized Bosniak III renal lesions accounted for 66%. Initially, cystic complexity was visualized in native B-mode. In none of the renal lesions hypervascularization was detected in Color Doppler. CEUS allowed for detection of contrast enhancement patterns in all included Bosniak III renal lesions. Delayed wash-out could be detected in 6/29 renal lesions. In two cases of histopathologically confirmed clear-cell RCC, appropriate up-grading from Bosniak IIF to III was achieved by CEUS. Conclusions: CEUS depicts a promising imaging modality for the precise diagnostic workup and stratification of renal cystic lesions according to the Bosniak classification system, thereby helping guidance of adequate clinical management in the future.

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“…One patient (patient 5) in whom a 1.6 cm measuring progressive lesion was upwardly categorized to Bosniak 3 subtype by CEUS, further, which even was upwardly classified to Bosniak 4 category due to MRI findings, underwent partial nephrectomy, and histopathology finally revealed leiomyoma. Prior findings already demonstrated the diagnostic challenge to distinguish small-sized benign renal tumors, including leiomyoma, especially from small RCCs [56,57]. Two patients in whom progression to Bosniak 3 category was observed, declined urological resection, thus histopathological correlation is lacking.…”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Ultrasound (CEUS) for Follow-Up of Bosniak 2F Complex Renal Cystic Lesions—A 12-Year Retrospective Study in a Specialized European Center

Rübenthaler

Čečatka

Froelich

et al. 2020

Cancers

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Bosniak 2F renal cystic lesions feature morphologic characteristics between Bosniak I and III categories, the majority of which remain benign. However, a minor part of Bosniak 2F lesions may progress to malignancy. The purpose of this study was to assess Bosniak 2F cystic lesions during follow-up examinations by CEUS. One-hundred-and-twelve out of 364 patients with Bosniak 2F lesions underwent follow-up CEUS examinations between February 2008 and February 2020. Twelve out of 364 patients underwent renal surgery without follow-up CEUS. The progression rate of Bosniak 2F renal lesions detected by CEUS accounted for 7.1% (8/112 patients) after a mean of 12.9 months. The first follow-up CEUS revealed 75% of progressions (6/8), the remaining 25% (2/8) of progressions were detected during second follow-up CEUS. Underlying clear-cell renal cell carcinoma was histopathologically validated in 5/8 progressive complex cystic renal lesions. Stable sonomorphologic features were observed in 92.1% (104/112 patients). CEUS depicts a promising diagnostic imaging modality in the diagnostic work-up and follow-up of complex renal cystic lesions at higher spatial and temporal resolutions than CT or MRI. Its excellent safety profile, its easy and repeatable accessibility, and low financial costs render CEUS an attractive and powerful alternative imaging tool for monitoring complex renal cystic lesions.

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Single-center study: the diagnostic performance of contrast-enhanced ultrasound (CEUS) for assessing renal oncocytoma

Cited by 17 publications

References 29 publications

Advanced Fusion Imaging and Contrast-Enhanced Imaging (CT/MRI–CEUS) in Oncology

Advanced Fusion Imaging and Contrast-Enhanced Imaging (CT/MRI–CEUS) in Oncology

Contrast-Enhanced Ultrasound (CEUS) for the Evaluation of Bosniak III Complex Renal Cystic Lesions—A 10-Year Specialized European Single-Center Experience with Histopathological Validation

Contrast-Enhanced Ultrasound (CEUS) for Follow-Up of Bosniak 2F Complex Renal Cystic Lesions—A 12-Year Retrospective Study in a Specialized European Center

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