To investigate the usefulness of contrast-enhanced ultrasound (CEUS) in the evaluation of renal masses.
This study included 255 patients with renal masses. Ages ranged from 18–86 years. CEUS was used for determining malignancy or benignancy and findings were correlated with the histopathological outcome. Out of 255 lesions, 212 lesions were malignant (83.1%) and 43 were benign (16.9%). Diagnostic accuracy was tested using the histopathological diagnosis as the gold standard.
CEUS showed a sensitivity of 99.1% [95% confidence interval (CI): 96.7%, 99.9%], a specificity of 80.5% (CI: 65.1%, 91.2%), a positive predictive value of 96.4% (CI: 93.0%, 98.4%) and a negative predictive value of 94.3% (CI: 80.8%, 99.3%). Kappa for diagnostic accuracy was κ = 0.85 (CI: 0.75, 0.94). Of 212 malignant lesions, 200 renal cell carcinomas and 12 other malignant lesions were diagnosed. Out of 43 benign lesions, 10 angiomyolipomas, 3 oncocytomas, 8 renal cysts and 22 other benign lesions were diagnosed.
CEUS is an useful method to differentiate between malignant and benignant renal lesions. To date, to our knowledge, this is the largest study in Europe for the evaluation of renal lesions using CEUS with a histopathological validation.
• CEUS helps clinicians detect and characterise unclear solid and cystic renal lesions
• CEUS shows a high diagnostic accuracy in the characterization of these lesions
• Proper surgical treatment or follow-up can be given with better diagnostic confidence
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Contrast-enhanced computed tomography
Negative predictive value
Picture archiving and communication system
Positive predictive value
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The authors state that this work has not received any funding.
The scientific guarantor of this publication is Prof. Dirk-André Clevert.
Conflict of interest
The authors of this manuscript declare relationships with the following companies: Dirk-André Clevert declares that he received compensation as a speaker from the following companies: Samsung, Philips, Siemens, Bracco, and Falk.
The other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
Dipl.-Stat. Regina Schinner (Department of Radiology, LMU Munich) kindly provided statistical advice for this manuscript. She is not an author of the manuscript.
Written informed consent was waived by the institutional review board.
Institutional review board approval was obtained.
• diagnostic prognostic study
• performed at one institution
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Rübenthaler, J., Negrão de Figueiredo, G., Mueller-Peltzer, K. et al. Evaluation of renal lesions using contrast-enhanced ultrasound (CEUS); a 10-year retrospective European single-centre analysis. Eur Radiol 28, 4542–4549 (2018). https://doi.org/10.1007/s00330-018-5504-1
- Carcinoma, renal cell
- Contrast media
- Perfusion imaging