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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Application of Contrast-enhanced Ultrasound and Bosniak Classification to the Diagnosis of Cystic Renal Masses

Author(s): Mei-Feng Huang, Zhi Zhang, Qing-Qing Xia, Xi-Ling Zhou, Xin-Chun Yuan* and Zhi-Yu Zhou

Volume 18, Issue 14, 2022

Published on: 13 July, 2022

Article ID: e090522204425 Pages: 9

DOI: 10.2174/1573405618666220509120959

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Abstract

Background: The Bosniak classification system based on contrast-enhanced computed tomography (CECT) is commonly used for the differential diagnosis of cystic renal masses. Contrastenhanced ultrasound (CEUS) is a relatively novel technique, which has gradually played an important role in the diagnosis of cystic renal cell carcinoma (CRCC) due to its safety and lowest price.

Objective: The aim of the study is to investigate the application value of CEUS and Bosniak classification into the diagnosis of cystic renal masses.

Methods: 32 cystic masses from January 2018 to December 2019 were selected. The images of conventional ultrasound (US), CEUS and CECT from subjects confirmed by surgical pathology were retrospectively analyzed. The Bosniak classification system of cystic renal masses was implemented using CEUS and CECT, and the diagnostic ability was compared.

Results: For the 32 cystic masses, postoperative pathology confirmed 11 cases of multilocular CRCC, 15 cases of clear cell carcinoma with hemorrhage, necrosis and cystic degeneration, 5 cases of renal cysts, and 1 case of renal tuberculosis. The Bosniak classification based on CEUS was higher than that based on CECT, and the difference was statistically significant (P = .024). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS were comparable to CECT. There was no significant difference observed in the diagnosis of CRCC (P >.05).

Conclusion: CEUS combined with Bosniak classification greatly improves the diagnosis of CRCC. CEUS shows a comparable diagnostic ability to CECT. In daily clinical routine, patients who require multiple examinations and present contraindications for CECT can particularly benefit from CEUS.

Keywords: Contrast-enhanced ultrasonography, contrast-enhanced computed tomography, bosniak classification, cystic masses, cystic renal cell carcinoma, diagnosis.

Graphical Abstract

[1]
Hélénon O, Crosnier A, Verkarre V, Merran S, Méjean A, Correas JM. Simple and complex renal cysts in adults: Classification system for renal cystic masses. Diagn Interv Imaging 2018; 99(4): 189-218.
[http://dx.doi.org/10.1016/j.diii.2017.10.005] [PMID: 29482969]
[2]
Hindman NM. Cystic renal masses. Abdom Radiol (NY) 2016; 41(6): 1020-34.
[http://dx.doi.org/10.1007/s00261-016-0761-4] [PMID: 27154722]
[3]
Laperrière J, Filion R, Houde M, Charghi A. Renal cell carcinoma presenting as multilocular cystic mass. Urology 1986; 28(2): 155-8.
[http://dx.doi.org/10.1016/0090-4295(86)90111-1] [PMID: 3739123]
[4]
Lerchbaumer MH, Putz FJ, Rübenthaler J, et al. Contrast-enhanced ultrasound (CEUS) of cystic renal lesions in comparison to CT and MRI in a multicenter setting. Clin Hemorheol Microcirc 2020; 75(4): 419-29.
[http://dx.doi.org/10.3233/CH-190764] [PMID: 32039837]
[5]
Bosniak MA. The current radiological approach to renal cysts. Radiology 1986; 158(1): 1-10.
[http://dx.doi.org/10.1148/radiology.158.1.3510019] [PMID: 3510019]
[6]
Bosniak MA. The use of the Bosniak classification system for renal cysts and cystic tumors. J Urol 1997; 157(5): 1852-3.
[http://dx.doi.org/10.1016/S0022-5347(01)64883-3] [PMID: 9112545]
[7]
Oh TH, Seo IY. The role of Bosniak classification in malignant tumor diagnosis: A single institution experience. Investig Clin Urol 2016; 57(2): 100-5.
[http://dx.doi.org/10.4111/icu.2016.57.2.100] [PMID: 26981591]
[8]
Schoots IG, Zaccai K, Hunink MG, Verhagen PCMS. Bosniak classification for complex renal cysts reevaluated: A systematic review. J Urol 2017; 198(1): 12-21.
[http://dx.doi.org/10.1016/j.juro.2016.09.160] [PMID: 28286071]
[9]
Butler M, Perperidis A, Zahra JM, et al. Differentiation of vascular characteristics using contrast-enhanced ultrasound imaging. Ultrasound Med Biol 2019; 45(9): 2444-55.
[http://dx.doi.org/10.1016/j.ultrasmedbio.2019.05.015] [PMID: 31208880]
[10]
Lassau N, Bonastre J, Kind M, et al. Validation of dynamic contrast-enhanced ultrasound in predicting outcomes of antiangiogenic therapy for solid tumors: The French multicenter support for innovative and expensive techniques study. Invest Radiol 2014; 49(12): 794-800.
[http://dx.doi.org/10.1097/RLI.0000000000000085] [PMID: 24991866]
[11]
Siracusano S, Bertolotto M, Ciciliato S, Valentino M, Liguori G, Visalli F. The current role of contrast-enhanced ultrasound (CEUS) imaging in the evaluation of renal pathology. World J Urol 2011; 29(5): 633-8.
[http://dx.doi.org/10.1007/s00345-011-0699-7] [PMID: 21604017]
[12]
Piscaglia F, Bolondi L. The safety of Sonovue in abdominal applications: Retrospective analysis of 23188 investigations. Ultrasound Med Biol 2006; 32(9): 1369-75.
[http://dx.doi.org/10.1016/j.ultrasmedbio.2006.05.031] [PMID: 16965977]
[13]
Osipov M, Vazhenin A, Kuznetsova A, Aksenova I, Vazhenina D, Sokolnikov M. PET-CT and occupational exposure in oncological patients. Sci Med J 2020; 2(2): 63-9.
[http://dx.doi.org/10.28991/SciMedJ-2020-0202-3]
[14]
Graumann O, Osther SS, Karstoft J, Hørlyck A, Osther PJ. Bosniak classification system: A prospective comparison of CT, contrast-enhanced US, and MR for categorizing complex renal cystic masses. Acta Radiol 2016; 57(11): 1409-17.
[http://dx.doi.org/10.1177/0284185115588124]
[15]
Lee CH, Liu JJK, Zheng Y, Tan CH. Bosniak classification of cystic renal masses: Utility of contrastenhanced ultrasound using version 2019. Med Ultrason 2020; 22(3): 279-86.
[http://dx.doi.org/10.11152/mu-2517] [PMID: 32898202]
[16]
Hélénon O, Correas JM, Balleyguier C, Ghouadni M, Cornud F. Ultrasound of renal tumors. Eur Radiol 2001; 11(10): 1890-901.
[http://dx.doi.org/10.1007/s003300101077] [PMID: 11702121]
[17]
Hulnick DH, Bosniak MA. “Faceless kidney”: CT sign of renal duplicity. J Comput Assist Tomogr 1986; 10(5): 771-2.
[http://dx.doi.org/10.1097/00004728-198609000-00012] [PMID: 3745548]
[18]
Kosvyra A, Maramis C, Chouvarda I. Developing an integrated genomic profile for cancer patients with the use of NGS data. Emerg Sci J 2019; 3(3): 157-67.
[http://dx.doi.org/10.28991/esj-2019-01178]
[19]
Kazmierski B, Deurdulian C, Tchelepi H, Grant EG. Applications of contrast-enhanced ultrasound in the kidney. Abdom Radiol (NY) 2018; 43(4): 880-98.
[http://dx.doi.org/10.1007/s00261-017-1307-0] [PMID: 28856401]
[20]
Rübenthaler J, Bogner F, Reiser M, Clevert DA. Contrast-Enhanced Ultrasound (CEUS) of the Kidneys by Using the Bosniak Classification. Ultraschall in der Medizin 2016; 37(3): 234-51.
[21]
Israel GM, Bosniak MA. How I do it: Evaluating renal masses. Radiology 2005; 236(2): 441-50.
[http://dx.doi.org/10.1148/radiol.2362040218] [PMID: 16040900]
[22]
Robbin ML, Lockhart ME, Barr RG. Renal imaging with ultrasound contrast: Current status. Radiol Clin North Am 2003; 41(5): 963-78.
[http://dx.doi.org/10.1016/S0033-8389(03)00070-8] [PMID: 14521204]
[23]
Harisinghani MG, Maher MM, Gervais DA, et al. Incidence of malignancy in complex cystic renal masses (Bosniak category III): Should imaging-guided biopsy precede surgery? AJR Am J Roentgenol 2003; 180(3): 755-8.
[http://dx.doi.org/10.2214/ajr.180.3.1800755] [PMID: 12591691]
[24]
Bertolotto M, Bucci S, Valentino M, Currò F, Sachs C, Cova MA. Contrast-enhanced ultrasound for characterizing renal masses. Eur J Radiol 2018; 105: 41-8.
[http://dx.doi.org/10.1016/j.ejrad.2018.05.015] [PMID: 30017297]
[25]
Xu Y, Zhang S, Wei X, Pan Y, Hao J. Contrast enhanced ultrasonography prediction of cystic renal mass in comparison to histopathology. Clin Hemorheol Microcirc 2014; 58(3): 429-38.
[http://dx.doi.org/10.3233/CH-131799] [PMID: 24165574]
[26]
Ascenti G, Mazziotti S, Zimbaro G, et al. Complex cystic renal masses: Characterization with contrast-enhanced US. Radiology 2007; 243(1): 158-65.
[http://dx.doi.org/10.1148/radiol.2431051924] [PMID: 17392251]
[27]
Ignee A, Straub B, Brix D, Schuessler G, Ott M, Dietrich CF. The value of contrast enhanced ultrasound (CEUS) in the characterisation of patients with renal masses. Clin Hemorheol Microcirc 2010; 46(4): 275-90.
[http://dx.doi.org/10.3233/CH-2010-1352] [PMID: 21187576]
[28]
Ragel M, Nedumaran A, Makowska-Webb J. Prospective comparison of use of contrast-enhanced ultrasound and contrast-enhanced computed tomography in the Bosniak classification of complex renal cysts. Ultrasound 2016; 24(1): 6-16.
[http://dx.doi.org/10.1177/1742271X15626959] [PMID: 27433270]
[29]
Nicolau Molina C, Fontanilla Echeveste T, Del Cura Rodríguez JL, et al. Utilidad de la ecografía con contraste en la práctica clínica diaria. Estudio multicéntrico español CEUS. Radiologia (Madr) 2010; 52(2): 144-52. [Usefulness of contrast-enhanced ultrasonography in daily clinical practice: A multicenter study in Spain
[http://dx.doi.org/10.1016/j.rx.2009.11.005]
[30]
Rübenthaler J, Paprottka KJ, Marcon J, Reiser M, Clevert DA. MRI and contrast enhanced ultrasound (CEUS) image fusion of renal lesions. Clin Hemorheol Microcirc 2016; 64(3): 457-66.
[http://dx.doi.org/10.3233/CH-168116] [PMID: 27886003]

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