Management of Indeterminate Cystic Kidney Lesions: Review of Contrast-enhanced Ultrasound as a Diagnostic Tool.

Emily H Chang, Wui K Chong, Sandeep K Kasoji, Paul A Dayton, W Kimryn Rathmell

Journal: Urology 2016;87():1-10

PMID: 26483268

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Abstract

Indeterminate cystic kidney lesions found incidentally are an increasingly prevalent diagnostic challenge. Standard workup includes Bosniak classification with contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI). However, these tests are costly and not without risks. Contrast-enhanced ultrasound (CEUS) is a relatively new technique with lower risk of adverse events than iodine-containing contrast or gadolinium. In our review of the evidence for characterization of cystic kidney lesions with CEUS, CEUS displayed sensitivity (89%-100%) and negative predictive value (86%-100%) comparable to contrast-enhanced CT or MRI, with no decrease in specificity compared with CT and only a slight decrease compared with MRI.

Address: Department of Medicine, Division of Nephrology and Hypertension, UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: [email protected].; Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.; Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC and North Carolina State at Raleigh, Raleigh, NC.; Department of Medicine, Division of Hematology and Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.

DOI: 10.1016/j.urology.2015.10.002

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MeSH Terms: Contrast Media, Diagnosis, Differential, Disease Management, Humans, Kidney Diseases, Cystic, Ultrasonography