Evaluation of Indeterminate Renal Masses with CEUS

Abstract

PurposeTo evaulate the utility of CEUS in evaluating indeterminate renal masses.Material & MethodsThe records of 721 patients referred over 11 years for CEUS for an indeterminate renal mass identified on another imaging study were reviewed. Exams prompting the CEUS were reviewed for Bozniac classification. State-of-the-art equipment at the time the exams was used. Definity and Optison were used at recommended doses for the contrast-specific software at that time exams were performed. One to three doses were utilized. Lesions were classified as benign or malignant based on lesion blood flow as previously described.ResultsCEUS was performed in 721 patients who had 1018 lesions (2-161mm). Of these lesions 306 (30.0%) had a confirmed diagnosis after work-up while 712 (70.0%) continued in follow-up. Of the 306 lesions with definitive diagnosis, 142 (46.4%) were malignant and 164 (53.6%) were benign. CEUS classified 142/142 pathologic malignant lesions as malignant and 159/164 pathologic benign lesions as benign, resulting in a positive predictive value of 100% and a negative predictive value of 97%. Of the 712 lesions without definitive diagnosis 673 (94.5%) were classified as benign, 32 (4.5%) were classified as malignant, and 7 (1.0%) were classified as indeterminate.ConclusionCEUS can characterize indeterminate renal masses with high positive or negative predictive value. PurposeTo evaulate the utility of CEUS in evaluating indeterminate renal masses. To evaulate the utility of CEUS in evaluating indeterminate renal masses. Material & MethodsThe records of 721 patients referred over 11 years for CEUS for an indeterminate renal mass identified on another imaging study were reviewed. Exams prompting the CEUS were reviewed for Bozniac classification. State-of-the-art equipment at the time the exams was used. Definity and Optison were used at recommended doses for the contrast-specific software at that time exams were performed. One to three doses were utilized. Lesions were classified as benign or malignant based on lesion blood flow as previously described. The records of 721 patients referred over 11 years for CEUS for an indeterminate renal mass identified on another imaging study were reviewed. Exams prompting the CEUS were reviewed for Bozniac classification. State-of-the-art equipment at the time the exams was used. Definity and Optison were used at recommended doses for the contrast-specific software at that time exams were performed. One to three doses were utilized. Lesions were classified as benign or malignant based on lesion blood flow as previously described. ResultsCEUS was performed in 721 patients who had 1018 lesions (2-161mm). Of these lesions 306 (30.0%) had a confirmed diagnosis after work-up while 712 (70.0%) continued in follow-up. Of the 306 lesions with definitive diagnosis, 142 (46.4%) were malignant and 164 (53.6%) were benign. CEUS classified 142/142 pathologic malignant lesions as malignant and 159/164 pathologic benign lesions as benign, resulting in a positive predictive value of 100% and a negative predictive value of 97%. Of the 712 lesions without definitive diagnosis 673 (94.5%) were classified as benign, 32 (4.5%) were classified as malignant, and 7 (1.0%) were classified as indeterminate. CEUS was performed in 721 patients who had 1018 lesions (2-161mm). Of these lesions 306 (30.0%) had a confirmed diagnosis after work-up while 712 (70.0%) continued in follow-up. Of the 306 lesions with definitive diagnosis, 142 (46.4%) were malignant and 164 (53.6%) were benign. CEUS classified 142/142 pathologic malignant lesions as malignant and 159/164 pathologic benign lesions as benign, resulting in a positive predictive value of 100% and a negative predictive value of 97%. Of the 712 lesions without definitive diagnosis 673 (94.5%) were classified as benign, 32 (4.5%) were classified as malignant, and 7 (1.0%) were classified as indeterminate. ConclusionCEUS can characterize indeterminate renal masses with high positive or negative predictive value. CEUS can characterize indeterminate renal masses with high positive or negative predictive value.