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Magnetic resonance imaging as an adjunct diagnostic tool in computed tomography defined Bosniak IIF–III renal cysts: a multicenter study

World Journal of Urology volume 36, pages 905–911 (2018)Cite this article

Abstract

Introduction

CT imaging is the standard examination for renal cystic lesions and defines the Bosniak category, which dictates further management. Given that Bosniak II/IIF/III renal cystic lesions can potentially harbor renal cell carcinoma (RCC), additional diagnostic modalities may be required in management decision making.

Aim

To determine the value of additional magnetic resonance imaging in CT-defined Bosniak IIF–III renal cystic lesions.

Materials and methods

This a multicenter retrospective study of 46 consecutive patients, diagnosed with cystic renal lesions between 2009 and 2016. The inclusion criteria were: (1) cystic renal lesion classified as Bosniak IIF–III on CT, (2) a subsequent MRI examination, and (3) documented outcome via surgery for cystic renal mass or follow-up.

Results

46 patients (35 males, 11 females) were included. The mean size of the cystic lesion was 3.92 cm (0.7–10 cm). According to the CT findings, Bosniak IIF and III were found in 12 (26.1%) and 34 (73.9%) cases. Reclassification of Bosniak category was done after MRI examination in 31 cases (67.4%). An upgrade rate of 58.7% (27 cases) to a higher category was made, while the downgrade rate to a lower category was achieved in 4 cases (8.7%). As a result, significant therapeutic management change was made in 12/31 patients (38.7%), of whom 8 underwent subsequent surgery.

Conclusion

MRI study may reduce the use of Bosniak IIF category (in comparison with CT), which has a direct impact on therapeutic management (surgery vs. surveillance) in a significant proportion of patients.

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Acknowledgements

This work was supported by MH CZ – DRO, the Charles University Research Fund (project number Q39), by the National Sustainability Program I (NPU I) Nr. LO1503 provided by the Ministry of Education Youth and Sports of the Czech Republic.

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Affiliations

  1. Department of Urology, Medical Faculty, Charles University, Charles University Hospital Plzen, E. Beneše 13, 305 99, Plzeň, Czech Republic

    Tomas Pitra, Ivan Travnicek, Kristyna Prochazkova & Milan Hora

  2. Department of Pathology, Medical Faculty, Charles University, Charles University Hospital Plzen, Plzeň, Czech Republic

    Kristyna Pivovarcikova & Ondrej Hes

  3. Department of Radiology, Medical Faculty, Charles University, Charles University Hospital Plzen, Plzeň, Czech Republic

    Radek Tupy & Tana Barakova

  4. Department of Pathology, Faculty of Medicine, University of British Columbia, Royal Columbian Hospital, Vancouver, BC, Canada

    Reza Alaghehbandan

  5. Department of Urology, Medical University of Vienna, Vienna, Austria

    Tobias Klatte

  6. Department of Urology, Jagiellonian University Medical College, Kraków, Poland

    Piotr Chlosta

Authors
  1. Tomas Pitra
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  2. Kristyna Pivovarcikova
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  3. Radek Tupy
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  4. Reza Alaghehbandan
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  5. Tana Barakova
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  6. Ivan Travnicek
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  7. Kristyna Prochazkova
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  8. Tobias Klatte
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  9. Piotr Chlosta
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  10. Ondrej Hes
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  11. Milan Hora
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Contributions

TP, project development, Manuscript writing, Data collection or management, Data analysis; KP, Manuscript writing/editing; RT and RA, Data analysis, Manuscript editing; TB, Data analysis; IT, KP and PC, Data collection or management; TK, Data collection or management, Manuscript editing; OH and MH, Manuscript editing.

Corresponding author

Correspondence to Tomas Pitra.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Retrospective study

For this type of study formal consent is not required.

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Pitra, T., Pivovarcikova, K., Tupy, R. et al. Magnetic resonance imaging as an adjunct diagnostic tool in computed tomography defined Bosniak IIF–III renal cysts: a multicenter study. World J Urol 36, 905–911 (2018). https://doi.org/10.1007/s00345-018-2176-z

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  • DOI: https://doi.org/10.1007/s00345-018-2176-z

Keywords

  • Renal cyst
  • Imaging
  • Kidney
  • Magnetic resonance
  • Cystic tumor