Feasibility of Contrast-Enhanced Intraoperative Ultrasound for Detection and Characterization of Renal Mass Undergoing Open Partial Nephrectomy.

Abstract

To determine the feasibility of obtaining intraoperative contrast-enhanced ultrasound (CEUS) imaging in patients undergoing open partial nephrectomy for renal cancer. We hypothesize that the study was feasible and the addition of CEUS would improve lesion identification and characterization. The study population consisted of 10 patients with known renal mass scheduled for intraoperative ultrasound-guided open partial nephrectomy. After dissection and exposure of the kidney by the surgeon, an intraoperative pre- and post-CEUS was performed by the radiologist. Feasibility was defined as successful imaging in 8 of 10 patients with intraoperative CEUS. Image quality, lesion conspicuity/contrast, lesion vascularity, morphology, and size were assessed and graded with pre- and post-contrast images. Intraoperative ultrasound was successfully acquired in 10 of 11 patients for renal mass detection and characterization. One study was canceled intraoperatively as a result of clinical complications related to a difficult surgery. Tumor size ranged from 1.3 to 4.2 cm. All lesions were solid. No additional lesions were found on CEUS compared with baseline imaging. Image quality post-contrast ranged from acceptable to excellent. There were no adverse events recorded for all 10 patients. In our feasibility study consisting of 10 patients, CEUS for detection and characterization of renal mass undergoing open partial nephrectomy was feasible and safe. Because intraoperative ultrasound during open partial nephrectomy can affect the extent of surgery, CEUS can be used to help detect and characterize renal mass for surgical planning/resection intraoperatively.