Prospective comparison of contrast-enhanced ultrasound and magnetic resonance imaging to computer tomography for the evaluation of complex cystic renal lesions.

Tshering Vogel, Dechen W.; Kiss, Bernhard; Heverhagen, Johannes; Benackova, Katarina; Burkhard, Fiona; Müller, Martin; Uehlinger, Dominik; Arampatzis, Spyridon (2021). Prospective comparison of contrast-enhanced ultrasound and magnetic resonance imaging to computer tomography for the evaluation of complex cystic renal lesions. (In Press). Urology Elsevier 10.1016/j.urology.2021.04.032

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OBJECTIVE

To prospectively evaluate the diagnostic accuracy of contrast enhanced ultrasound (CEUS) and MRI compared to computed tomography (CT) as the current gold standard for the characterization of cystic renal lesions using the Bosniak classification.

METHODS

Between July 2014 and October 2017 we prospectively enrolled patients with cystic renal lesions. Based on the Bosniak classification of complex renal lesions (≥BII-F) we evaluated the accuracy of observed agreement by Cohen's Kappa coefficient and calculated sensitivity, specificity, positive and negative predictive values (PPV/NPV) between the three imaging modalities CT, MRI and CEUS.

RESULTS

We evaluated 65 cystic renal lesions in 48 patients (median age 63 years, range 36-91 years; 18 females, 30 males). According to CT 29 (47%) of the cystic renal lesions were classified as complex. The agreement between CEUS and CT in the classification of complex cystic lesions was fair (agreement 50.8%, Kappa 0.31), and was excellent between MRI and CT (agreement 93.9%, Kappa 0.88). Compared to CT, CEUS and MRI had a sensitivity of 100% and 96.6%, a specificity of 33.3% and 91.7%, a PPV of 54.7% and 90.3%, and a NPV of 100% and 97.1% with an accuracy of 63.1% and 93.8% respectively.

CONCLUSION

CEUS has an excellent sensitivity and NPV and represents a promising non-invasive screening tool for renal cystic lesions. The classification of complex renal cysts based on MRI and CT scans correlated closely.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Tshering Vogel, Dechen Wangmo; Kiss, Bernhard; Heverhagen, Johannes; Benackova, Katarina; Burkhard, Fiona Christine; Müller, Martin; Uehlinger, Dominik and Arampatzis, Spyridon

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0090-4295

Publisher:

Elsevier

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

08 Jun 2021 09:24

Last Modified:

11 Jun 2021 01:34

Publisher DOI:

10.1016/j.urology.2021.04.032

PubMed ID:

33984367

Uncontrolled Keywords:

CEUS Comparative imaging studies Complex renal cysts MRI

BORIS DOI:

10.48350/156372

URI:

https://boris.unibe.ch/id/eprint/156372

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