Advertisement

Abdominal Imaging

, Volume 33, Issue 1, pp 44–47 | Cite as

Do all non-calcified echogenic renal lesions found on ultrasound need further evaluation with CT?

  • Cormac Farrelly
  • Holly Delaney
  • Ronan McDermott
  • Dermot Malone
Article

Abstract

Background

This is a study using Evidence Based Practice (EBP) technique to evaluate if non-calcified renal lesions detected with ultrasound, suspected to represent an angiomyolipoma (AML), need a CT to rule out a renal cell carcinoma (RCC).

Methods

The secondary and primary literature were searched for all relevant information. This was appraised for validity and strength. The results from the papers with the highest level of evidence were grouped together and analyzed.

Results

Three papers in the primary literature constituted the highest level of evidence. In total these three papers examined 220 lesions. The prevalence of AML was 45% in this sample. Overall, hyperechoic non-calcified renal lesions had a sensitivity of 0.99 (95% confidence interval (CI) 0.97–1.00), a specificity of 0.43 (95% CI 0.34–0.51), a positive predictive value (PPV) of 0.58 and a negative predictive value (NPV) of 0.98 for AMLs. 57.4% of RCCs were hyperechoic to renal parenchyma. Two of the studies found that posterior acoustic shadowing had a sensitivity of 0.34 (95% CI 0.40–0.56) and a specificity of 1.0 (95% CI 1.0–1.0) for AML.

Conclusions

From the surprisingly limited evidence available in the literature, it must be concluded that all non-calcified echogenic renal lesions detected with ultrasound need a CT to rule out an RCC.

Keywords

Renal Cell Carcinoma Positive Predictive Value Negative Predictive Value Renal Lesion Primary Literature 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Staunton M (2007) Evidence-based radiology: Steps 1 and 2—asking answerable questions and searching for evidence. Radiology 242(1):23–31Google Scholar
  2. 2.
    Dodd JD (2007) Evidence-based practice in radiology: Steps 3 and 4—appraise and apply diagnostic radiology literature. Radiology 242(2):342–354Google Scholar
  3. 3.
    Mindell HJ (1996) Do all homogeneously echogenic renal lesions that are smaller than 1.5 cm and are seen incidentally on sonograms (lesions presumed to be angiomyolipomas) require CT to confirm fat content of such lesions? AJR Am J Roentgenol 167(6):1590Google Scholar
  4. 4.
    Siegel CL, Middleton WD, Teefey SA, McClennan BL (1996) Angiomyolipoma and renal cell carcinoma: US differentiation. Radiology 198:789–793Google Scholar
  5. 5.
    Zebedin D, Kammerhuber F, Uggowitzer MM, Szolar DH (1998) Criteria for ultrasound differentiation of small angiomyolipomas (< or = 3 cm) and renal cell carcinomas. Rofo 169(6):627–632Google Scholar
  6. 6.
    Yamashita Y, Ueno S, Makita O, et al. (1993) Hyperehoic renal tumors: anechoic rim and intratumoral cysts in US differentiation of renal cell carcinoma from angiomyolipoma. Radiology 188:179–182Google Scholar
  7. 7.
    MacEneaney PM, Malone DE (2000) The meaning of diagnostic test results: a spreadsheet for swift data analysis. Clin Radiol 55:227–235Google Scholar
  8. 8.
    Mouraviev V, Joniau S, Van Poppel H, Polascik TJ (2007) Current status of minimally invasive ablative techniques in the treatment of small renal tumours. Eur Urol 51(2):328–336Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Cormac Farrelly
    • 1
  • Holly Delaney
    • 1
  • Ronan McDermott
    • 1
  • Dermot Malone
    • 2
  1. 1.Radiology DepartmentSt. James’s HospitalDublin 8Ireland
  2. 2.St. Vincent’s University HospitalDublin 4Ireland

Personalised recommendations