Wolfgang M Thaiss1, Jens Bedke2, Stephan Kruck3, Daniel Spira4, Arnulf Stenzl3, Konstantin Nikolaou1, Marius Horger1, Sascha Kaufmann1. 1. Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany. 2. Department of Urology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany. jens.bedke@med.uni-tuebingen.de. 3. Department of Urology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany. 4. Diagnostic and Interventional Radiology, University Medical Center Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
Abstract
PURPOSE: To prospectively characterize computed tomography (CT)-indeterminate renal masses (CTIRM) using acoustic radiation force impulse (ARFI) elastography and contrast-enhanced ultrasound (CEUS) and to correlate quantitative imaging findings with histopathology or interim follow-up (FU). METHODS: 123 patients with CTIRM (longest diameter < 4 cm) underwent ARFI and CEUS with CT image fusion (IF). Exclusion criteria included all contraindications for CEUS and IF. Shear wave velocity (SWV), shear wave ratio (SWR), peak intensity (PE), time to peak (TTP) and wash-in rate (Wi) were quantified. In case of a cystic lesion classified as ≤ Bosniak 2F, follow-up imaging was performed. RESULTS: 77 out of 123 patients underwent surgical resection of a lesion due to suspect imaging findings, whereas 46 patients underwent FU, which did not show upgrading in Bosniak category. Histopathology revealed 58 renal cell carcinomas [five chromophobe (chRCC), 18 papillary (pRCC) and 35 clear cell (ccRCC)], ten oncocytomas and nine non-malignant renal lesions (one minimal fat AML, three focal nephritis and five infected cysts). SWV and SWR differed significantly between ccRCC, pRCC, chRCC (p = 0.0024, F = 13.94) and in SWR also for oncocytoma (p < 0.0001, F = 14.35). In CEUS, oncocytoma and ccRCC showed significant higher PE values (p < 0.0001, F = 77.31) as well as higher Wi and lower TTP compared to all other solid lesions. CONCLUSIONS: Quantitative CEUS and ARFI imaging can provide relevant information to further characterize CT-indeterminate renal masses to guide urological decision making and offer the possibility of differentiation between ccRCC from less malignant RCC subtypes and from oncocytoma.
PURPOSE: To prospectively characterize computed tomography (CT)-indeterminate renal masses (CTIRM) using acoustic radiation force impulse (ARFI) elastography and contrast-enhanced ultrasound (CEUS) and to correlate quantitative imaging findings with histopathology or interim follow-up (FU). METHODS: 123 patients with CTIRM (longest diameter < 4 cm) underwent ARFI and CEUS with CT image fusion (IF). Exclusion criteria included all contraindications for CEUS and IF. Shear wave velocity (SWV), shear wave ratio (SWR), peak intensity (PE), time to peak (TTP) and wash-in rate (Wi) were quantified. In case of a cystic lesion classified as ≤ Bosniak 2F, follow-up imaging was performed. RESULTS: 77 out of 123 patients underwent surgical resection of a lesion due to suspect imaging findings, whereas 46 patients underwent FU, which did not show upgrading in Bosniak category. Histopathology revealed 58 renal cell carcinomas [five chromophobe (chRCC), 18 papillary (pRCC) and 35 clear cell (ccRCC)], ten oncocytomas and nine non-malignant renal lesions (one minimal fat AML, three focal nephritis and five infected cysts). SWV and SWR differed significantly between ccRCC, pRCC, chRCC (p = 0.0024, F = 13.94) and in SWR also for oncocytoma (p < 0.0001, F = 14.35). In CEUS, oncocytoma and ccRCC showed significant higher PE values (p < 0.0001, F = 77.31) as well as higher Wi and lower TTP compared to all other solid lesions. CONCLUSIONS: Quantitative CEUS and ARFI imaging can provide relevant information to further characterize CT-indeterminate renal masses to guide urological decision making and offer the possibility of differentiation between ccRCC from less malignant RCC subtypes and from oncocytoma.
Authors: Andre Ignee; Bernd Straub; David Brix; Gudrun Schuessler; Michaela Ott; Christoph F Dietrich Journal: Clin Hemorheol Microcirc Date: 2010 Impact factor: 2.375
Authors: Chaan S Ng; Christopher G Wood; Paul M Silverman; Nizar M Tannir; Pheroze Tamboli; Carl M Sandler Journal: AJR Am J Roentgenol Date: 2008-10 Impact factor: 3.959
Authors: Srinivasa R Prasad; Peter A Humphrey; Jay R Catena; Vamsi R Narra; John R Srigley; Arthur D Cortez; Neal C Dalrymple; Kedar N Chintapalli Journal: Radiographics Date: 2006 Nov-Dec Impact factor: 5.333
Authors: D-A Clevert; K Stock; B Klein; J Slotta-Huspenina; L Prantl; U Heemann; M Reiser Journal: Clin Hemorheol Microcirc Date: 2009 Impact factor: 2.375
Authors: D-A Clevert; N Minaifar; S Weckbach; E M Jung; K Stock; M Reiser; M Staehler Journal: Clin Hemorheol Microcirc Date: 2008 Impact factor: 2.375
Authors: Vasile Simon; Sorin Marian Dudea; Nicolae Crisan; Vasile Dan Stanca; Marina Dudea-Simon; Iulia Andras; Zoltan Attila Mihaly; Ioan Coman Journal: Diagnostics (Basel) Date: 2022-07-16