Evaluation of renal masses with contrast-enhanced ultrasound: Initial experience Journal Article
| Authors: | Gerst, S.; Hann, L. E.; Li, D.; Gonen, M.; Tickoo, S.; Sohn, M. J.; Russo, P. |
| Article Title: | Evaluation of renal masses with contrast-enhanced ultrasound: Initial experience |
| Abstract: | OBJECTIVE. Nearly 25% of solid renal tumors are indolent cancer or benign and can be managed conservatively in selected patients. This prospective study was performed to determine whether preoperative IV microbubble contrast-enhanced ultrasound can be used to differentiate indolent and benign renal tumors from more aggressive clear cell carcinoma. SUBJECTS AND METHODS. Thirty-four patients with renal tumors underwent preoperative gray-scale, color, power Doppler, and octafluoropropane microbubble IV contrast-enhanced ultrasound. Three blinded radiologists reading in consensus compared rate of contrast wash-in, grade and pattern of enhancement, and contrast washout compared with adjacent parenchyma. Contrast ultrasound findings were compared with surgical histopathologic findings for all patients. RESULTS. The 34 patients had 23 clear cell carcinomas, three type 1 papillary carcinomas, one chromophobe carcinoma, one clear rare multilocular low-grade malignant tumor, two unclassified lesions, three oncocytomas, and one benign angiomyolipoma. The combination of heterogeneous lesion echotexture and delayed lesion washout had 85% positive predictive value, 43% negative predictive value, 48% sensitivity, and 82% specificity for predicting whether a lesion was conventional clear cell carcinoma or another tumor. Diminished lesion enhancement grade had 75% positive predictive value, 81% negative predictive value, 55% sensitivity, and 91% specificity for non-clear cell histologic features, either benign or low-grade malignant. Combining delayed washout with quantitative lesion peak intensity of at least 20% of kidney peak intensity had 91% positive predictive value, 40% negative predictive value, 63% sensitivity, and 80% specificity in the prediction of clear cell histologic features. CONCLUSION. Ultrasound features of gray-scale heterogeneity, lesion washout, grade of contrast enhancement, and quantitative measure of peak intensity may be useful for differentiating clear cell carcinoma and non-clear cell renal tumors. © American Roentgen Ray Society. |
| Keywords: | adult; clinical article; controlled study; human tissue; aged; aged, 80 and over; middle aged; human cell; clinical feature; histopathology; cancer grading; preoperative evaluation; prospective study; sensitivity and specificity; prospective studies; controlled clinical trial; image analysis; differential diagnosis; diagnostic imaging; oncocytoma; kidney carcinoma; ultrasound; kidney neoplasms; color ultrasound flowmetry; kidney; ultrasonography, doppler, color; kidney tumor; angiomyolipoma; contrast enhancement; echography; predictive value of tests; contrast media; clear cell carcinoma; papillary carcinoma; predictive value; roc curve; iv contrast medium; microbubbles; perflutren; gray scale echography; microbubble; fluorocarbons |
| Journal Title: | American Journal of Roentgenology |
| Volume: | 197 |
| Issue: | 4 |
| ISSN: | 0361-803X |
| Publisher: | American Roentgen Ray Society |
| Date Published: | 2011-10-01 |
| Start Page: | 897 |
| End Page: | 906 |
| Language: | English |
| DOI: | 10.2214/ajr.10.6330 |
| PROVIDER: | scopus |
| PUBMED: | 21940577 |
| PMCID: | PMC3683974 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 November 2011" - "CODEN: AJROA" - "Source: Scopus" |
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