Differentiation Of Renal Masses Research Articles

Differentiation of renal masses with multi-parametric MRI: the de Silva St George classification scheme

PurposeTo develop a system for multi-parametric MRI to differentiate benign from malignant solid renal masses and assess its accuracy compared to the gold standard of histopathological diagnosis.MethodsThis is a retrospective analysis of patients who underwent 3 Tesla mpMRI for further assessment of small renal tumours with specific scanning and reporting protocol incorporating T2 HASTE signal intensity, contrast enhancement ratios, apparent diffusion coefficient and presence of microscopic/macroscopic fat. All MRIs were reported prior to comparison with histopathologic diagnosis and a reporting scheme was developed. 2 × 2 contingency table analysis (sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV)), Fisher Exact test were used to assess the association between suspicion of malignancy on mpMRI and histopathology, and descriptive statistics were performed.Results67 patients were included over a 5-year period with a total of 75 renal masses. 70 masses were confirmed on histopathology (five had pathognomonic findings for angiomyolipomas; biopsy was therefore considered unethical, so these were included without histopathology). Three patients were excluded due to a non-diagnostic result, non-standardised imaging and one found to be an organising haematoma rather than a mass. Therefore 72 cases were included in analysis (in 64 patients, with seven patients having multiple tumours). Unless otherwise specified, all further statistics refer to individual tumours rather than patients. 52 (72.2%) were deemed ‘suspicious or malignant’ and 20 (27.8%) were deemed ‘benign’ on mpMRI. 51 cases (70.8%) had renal cell carcinoma confirmed. The sensitivity, NPV, specificity and PPV for MRI for detecting malignancy were 96.1%, 90%, 85.7% and 94.2% respectively, Fisher’s exact test demonstrated p < 0.0001 for the association between suspicion of malignancy on MRI and histopathology.ConclusionThe de Silva St George classification scheme performed well in differentiating benign from malignant solid renal masses, and may be useful in predicting the likelihood of malignancy to determine the need for biopsy/excision. Further validation is required before this reporting system can be recommended for clinical use.

Diagnostic Accuracy of Multi-Detector CT for Evaluation of Renal Masses

Objective: To determine the accuracy of multi-detector computed tomography (MDCT) in differentiation of renal masses taking histopathology as gold standard. Methods: This cross-validation study was conducted from March 2021 to August 2021 at Al Hussain Diagnostic &amp; Medical center Nishtar Road Multan. We included 100 patients presenting with renal masses on clinical and ultrasonography. All patients underwent MDCT for evaluation of renal masses. After MDCT, biopsy specimens were obtained for histopathological diagnosis of renal masses. The MDCT findings were correlated with histopathology diagnosis to determine the accuracy of MDCT. Results: Mean age was 45.8±12.36 years, 67% patients were male and 33% were female. Malignancy was diagnosed in 83% patients and remaining 17% patients were diagnosed of having benign lesions. Out of malignant lesions, 65% patients had RCC, 07% Wilm’s tumor, 6% lymphoma, meta-stasis was diagnosed 04% patients and 01% renal pelvic TCC. Among the benign lesions 11% patients had Angiomyolipoma and oncocytoma was diagnosed in 6.0% patients. The overall sensitivity of CT scan was 97.6%, specificity was 100%, PPV was 100% and NPV was 89.5%. Conclusion: MDCT can be used as the imaging method of choice for initial evaluation and diagnosis of RCC as it is associated with high sensitivity and specificity for differentiating malignant from benign lesions. Keywords: Diagnostic Accuracy, Histopathology, Multi detector CT, Renal Masses

Solid renal masses: use of spiral Computed tomography for Differentiation between benign and malignant lesions

objective: To determine whether CT images on the basis of their morphologic features and enhancement patterns. could help accurately distinguish benign renal masses from malignant .patients and Methods : Between April 2006 and February 2009, 80 consecutive patients (age range, 1–65 years; 50 male, 30 female) suspected to have renal mass by physical examination ,underwent ultrasound examination to evaluate the mass ,whether cystic or solid. Only patients with solid renal mass documented with US were included in the study then preoperative renal CT. All CT studies evaluated the mass about the pattern and degree of enhancement, lesion contour, presence of neovascularity, and calcifications .Results: Of the 80 renal masses (median size, 3.4 cm; range, 1.1–20.0 cm) included in this study, 30 (37 %) were benign and 50 (63 %) were malignant. of benign 14 (47%)patients have abscess and 16(54 %) have angiomyolipoma , while malignant tumor classified as clear cell renal cell carcinomas (RCCs) 28 (56 %) , papillary lesions 16 (32 %) and 6 (12 %) Wilm's tumors. abscess most commonly classified as hypodense with peripheral enhancement while Clear cell RCC most commonly manifested with a mixed enhancement pattern of both hypervascular soft-tissue components and low-attenuation areas that corresponded to necrotic or cystic changes ,whereas the homogeneous and peripheral enhancing patterns were more predictive of less aggressive papillary . Clear cell RCCs tended to be hypervascular and angiomyolipomas tended to enhance moderately, and papillary lesions were mostly hypovascular.&#x0D; Conclusion: Certain imaging features and the degree of enhancement may be helpful in differentiation of renal masses .

298 Percutaneous needle based optical coherence tomography for the differentiation of renal masses

298 Percutaneous needle based optical coherence tomography for the differentiation of renal masses

Quantitative analysis of contrast-enhanced ultrasound in renal lesions: a preliminary study

Objective To investigate the value of quantitative analysis in the diagnosis of renal lesions with contrast-enhanced ultrasound.Methods Sixty cases with renal lesions confirmed by surgery and pathology underwent contrast-enhanced ultrasound preoperatively and quantitative analysis retrospectively.The Sonoliver software was applied in the analysis of CEUS imaging and in the recoustruction of quantitative parameter,s.Five parameters were calculated,including the maximum intensity (IMAX),rise time (RT),time to peak (TTP),mean transit time (mTT) and area under the curve (AUC).Results There were statistically differences in parameters RT,mTT and AUC ( P ＜ 0.05) and significant differences in parameter IMAX ( P ＜0.01).In malignant tumors,the RT and mTT were less than that of the benign while IMAX and AUC were more than that of the benign.Conclusions Contrast-enhanced ultrasound using a quantitative parametric analysis offers more information and is a promising tool in the diagnosis and differentiation of renal masses. Key words: Ultrasonography; Microbubbles; Kidney neoplasms

Assessment and characterisation of common renal masses with CT and MRI

ObjectiveOwing to the widespread use of abdominal imaging studies the detection rate of solid renal masses has increased, and an accurate characterisation of imaging features of renal masses has become more essential for case management.Method and resultsMR imaging (MRI) and computed tomography (CT) are frequently used modalities for detection and differentiation of renal masses. This article gives a review of imaging characteristics of benign and malignant renal masses, discussing their appearance in CT and MR imaging. Advanced MR techniques like diffusion-weighted imaging and apparent diffusion coefficient (ADC) mapping, which have shown promising results in the differentiation between benign and malignant renal lesions, will be introduced.ConclusionMRI and CT are useful in the characterisation and estimation of the prognosis for renal masses.

Usefulness of contrast-enhanced harmonic sonography in renal cell cancer and angiomyolipoma

Objective To characterize the image morphology and time-intensity curve of renal cell cancer and angiomyolipoma on contrast-enhanced harmonic sonography. Methods A total of 57 patients with 58 renal masses were enrolled in this study prospectively. The renal masses included 47 renal cell carcinomas (RCC) and 11 angiomyolipomas (AML). All patients were evaluated by tradi-tional gray-scale sonography, color Doppler sonography and contrast-enhanced harmonic sonography. Imaging findings and time-intensity curves of all renal masses were analyzed. The contrast-enhance-ment features between RCC and AML were analyzed. Results 57.4% of RCCs were hyperechoic masses and peripheral surrounding vessels and / or penetrating vessels were noted in 83.0% of RCCs on color Doppler sonography. 54.5 % of AMLs were hyperechoic masses while peripheral surrounding vessels and / or penetrating vessels were only noted in 27.3% of AMLs on color Doppler sonography. On contrast-enhanced harmonic sonography, hyper- or iso-enhancement were noted in 83.0% of RCCs, while hypo-enhancement were noted in 81.8% of AMLs (P<0.01). Statistically significant differences were noted between RCC and AML in the values of peak time (P=0.03), wash time (p= 0.02), peak intensity-basic intensity (P=0. 01), AT/R (△A tumor/△A renal) (P=0.00), k (P= 0.02), and Aok (P=0.02). Conclusions Contrast-enhanced sonography is useful in the differentia-tion of renal masses. Most RCCs are hyper- or iso-enhanced while most AMLs are hypo-enhanced. Time-intensity curves are helpful in differentiating RCC and AML. Key words: Carcinoma,renal cell; Angiomyolipoma; Sonography; Contrast media

Recent Advances in Diagnostic Ultrasound.

Compiled and edited by a nuclear radiologist who also uses diagnostic ultrasound, this book is intended to bring diagnostic ultrasound to the attention of practicing physicians. It is anticipated that conditions such as tumor masses and others will now be investigated by this new diagnostic modality. Some of the more common applications of diagnostic ultrasound such as detection of pericardial fluid, differentiation of renal masses, and mid-line echo encephalography are dealt with by a combined nuclear radiology and ultrasound approach. It is the authors' belief that the dual diagnostic approach improves the results as compared to either method alone. These points are illustrated with nuclear images and ultrasonograms; the latter are of poor quality. The editor's goals might best be satisfied by those portions of the book which deal with scanning in upper abdominal disease, the determination of fetal head size, and placental localization. Considerable expertise is evident in

Differentiation of Renal Masses Using A-mode Ultrasound

SummaryA unique property of ultrasound is its ability to differentiate between cystic and solid masses. Using nephrosonography, 150 renal masses were examined. In 144 of them (96 per cent), the physical state of the mass, that is fluid, solid or complex, was correctly predicted. Nephrosonography is uncomplicated, atraumatic and safe. It is used in conjunction with standard radiological methods of diagnosis such as IVP, nephrotomography and in selected cases with angiography, cyst aspiration and isotope scanning. Generally, when a solid ultrasonic pattern is obtained, arteriography is recommended. If a cystic pattern is obtained, nephrotomography followed by cyst puncture is usually all that is necessary. The treatment of masses producing complex ultrasonic patterns must be individualized. In this diagnostic setting, it should be possible to differentiate benign from malignant renal masses with an accuracy approaching 99 per cent.