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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

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-...

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Main Authors: Schwarze, Vincent (Author) , Rübenthaler, Johannes (Author) , Čečatka, Saša (Author) , Marschner, Constantin (Author) , Froelich, Matthias F. (Author) , Sabel, Bastian Oliver (Author) , Staehler, Michael (Author) , Knösel, Thomas (Author) , Geyer, Thomas (Author) , Clevert, Dirk-André (Author)
Format: Article (Journal)
Language:English
Published: 12 December 2020
In: Medicina
Year: 2020, Volume: 56, Issue: 12, Pages: 1-16
ISSN:1648-9144
DOI:10.3390/medicina56120692
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/medicina56120692
Verlag, kostenfrei, Volltext: https://www.mdpi.com/1648-9144/56/12/692
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Author Notes:Vincent Schwarze, Johannes Rübenthaler, Saša Čečatka, Constantin Marschner, Matthias Frank Froelich, Bastian Oliver Sabel, Michael Staehler, Thomas Knösel, Thomas Geyer and Dirk-André Clevert
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Summary: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.
Item Description:Gesehen am 29.04.2024
Physical Description:Online Resource
ISSN:1648-9144
DOI:10.3390/medicina56120692

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