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Use of lumason/sonovue in contrast-enhanced ultrasound of the kidney for characterization of renal masses—a meta-analysis

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Abstract

Indeterminate renal masses are a common clinical problem. CEUS has several advantages to characterize both cystic and solid renal masses including thin slice thickness, excellent background subtraction, and real-time imaging with a high frame rate. The ultrasound contrast agents are not nephrotoxic and can be used in patients with renal insufficiency and obstruction. The Bosniak classification has been developed for use in CT and MRI. A CEUS Bosniak classification has not yet been developed. This meta-analysis reviews the results of renal mass characterization using Lumason/Sonovue in characterizing renal solid and cystic masses. For complex cystic renal lesions (419 patients; 436 lesions), the pooled sensitivity and specificity of CEUS were 95% (95% CI: 91%, 99%) and 84% (95% CI: 77%, 90%) and for solid lesions (331 patients; 341 lesions), the pooled sensitivity and specificity of CEUS were 98% (95% CI: 95%, 100%) and 78% (95% CI: 68%, 88%), respectively.

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References

  1. 1.Barr, R.G., C. Peterson, and A. Hindi, Evaluation of indeterminate renal masses with contrast-enhanced US: a diagnostic performance study. Radiology, 2014. 271(1): p. 133-42.

    Article  PubMed  Google Scholar 

  2. 2.Tada, S., et al., The incidence of simple renal cyst by computed tomography. Clin Radiol, 1983. 34(4): p. 437-9.

    Article  CAS  PubMed  Google Scholar 

  3. 3.Silverman, S.G., et al., Management of the incidental renal mass. Radiology, 2008. 249(1): p. 16-31.

    Article  PubMed  Google Scholar 

  4. 4.Bosniak, M.A., The current radiological approach to renal cysts. Radiology, 1986. 158(1): p. 1-10.

    Article  CAS  PubMed  Google Scholar 

  5. 5.Silverman, S.G., et al., Bosniak Classification of Cystic Renal Masses, Version 2019: An Update Proposal and Needs Assessment. Radiology, 2019. 292(2): p. 475-488.

    Article  PubMed  Google Scholar 

  6. 6.Bosniak, M.A., Diagnosis and management of patients with complicated cystic lesions of the kidney. AJR Am J Roentgenol, 1997. 169(3): p. 819-21.

    Article  CAS  PubMed  Google Scholar 

  7. 7.Israel, G.M. and M.A. Bosniak, Follow-up CT of moderately complex cystic lesions of the kidney (Bosniak category IIF). AJR Am J Roentgenol, 2003. 181(3): p. 627-33.

    Article  PubMed  Google Scholar 

  8. 8.Barr, R.G., et al., Contrast-enhanced Ultrasound-State of the Art in North America: Society of Radiologists in Ultrasound White Paper. Ultrasound Q, 2020. 36(4S Suppl 1): p. S1-S39.

    Article  PubMed  Google Scholar 

  9. https://www.fda.gov/radiation-emitting-products/initiative-reduce-unnecessary-radiation-exposure-medical-imaging/white-paper-initiative-reduce-unnecessary-radiation-exposure-medical-imaging.

  10. 10.Wilson, S.R. and P.N. Burns, Microbubble-enhanced US in body imaging: what role? Radiology, 2010. 257(1): p. 24-39.

    Article  PubMed  Google Scholar 

  11. 11.Piscaglia, F., et al., The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall Med, 2012. 33(1): p. 33-59.

    Article  CAS  PubMed  Google Scholar 

  12. 12.Robbin, M.L., M.E. Lockhart, and R.G. Barr, Renal imaging with ultrasound contrast: current status. Radiol Clin North Am, 2003. 41(5): p. 963-78.

    Article  PubMed  Google Scholar 

  13. 13.Sanchez, K. and R.G. Barr, Contrast-enhanced ultrasound detection and treatment guidance in a renal transplant patient with renal cell carcinoma. Ultrasound Q, 2009. 25(4): p. 171-3.

    Article  PubMed  Google Scholar 

  14. 14.Tamai, H., et al., Contrast-enhanced ultrasonography in the diagnosis of solid renal tumors. J Ultrasound Med, 2005. 24(12): p. 1635-40.

    Article  PubMed  Google Scholar 

  15. 15.Correas, J.M., et al., The kidney: imaging with microbubble contrast agents. Ultrasound Q, 2006. 22(1): p. 53-66.

    PubMed  Google Scholar 

  16. 16.Mazziotti, S., et al., Usefulness of contrast-enhanced ultrasonography in the diagnosis of renal pseudotumors. Abdom Imaging, 2010. 35(2): p. 241-5.

    Article  PubMed  Google Scholar 

  17. 17.Ignee, A., et al., The value of contrast enhanced ultrasound (CEUS) in the characterisation of patients with renal masses. Clin Hemorheol Microcirc, 2010. 46(4): p. 275-90.

    Article  PubMed  Google Scholar 

  18. 18.Quaia, E., et al., Comparison of contrast-enhanced sonography with unenhanced sonography and contrast-enhanced CT in the diagnosis of malignancy in complex cystic renal masses. AJR Am J Roentgenol, 2008. 191(4): p. 1239-49.

    Article  PubMed  Google Scholar 

  19. 19.Clevert, D.A., et al., Multislice computed tomography versus contrast-enhanced ultrasound in evaluation of complex cystic renal masses using the Bosniak classification system. Clin Hemorheol Microcirc, 2008. 39(1-4): p. 171-8.

    Article  PubMed  Google Scholar 

  20. 20.Park, B.K., et al., Assessment of cystic renal masses based on Bosniak classification: comparison of CT and contrast-enhanced US. Eur J Radiol, 2007. 61(2): p. 310-4.

    Article  PubMed  Google Scholar 

  21. 21.Ascenti, G., et al., Complex cystic renal masses: characterization with contrast-enhanced US. Radiology, 2007. 243(1): p. 158-65.

    Article  PubMed  Google Scholar 

  22. 22.Egger, M., et al., Bias in meta-analysis detected by a simple, graphical test. BMJ, 1997. 315(7109): p. 629-34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. 23.Lu, Q., et al., Minimal fat renal angiomyolipoma: the initial study with contrast-enhanced ultrasonography. Ultrasound Med Biol, 2012. 38(11): p. 1896-901.

    Article  PubMed  Google Scholar 

  24. 24.Li, X., et al., Real-time contrast-enhanced ultrasound in diagnosis of solid renal lesions. Discov Med, 2013. 16(86): p. 15-25.

    CAS  PubMed  Google Scholar 

  25. 25.Xue, L.Y., et al., Contrast-enhanced ultrasonography for evaluation of cystic renal mass: in comparison to contrast-enhanced CT and conventional ultrasound. Abdom Imaging, 2014. 39(6): p. 1274-83.

    Article  PubMed  Google Scholar 

  26. 26.Wei, S.P., et al., Contrast-enhanced ultrasound for differentiating benign from malignant solid small renal masses: comparison with contrast-enhanced CT. Abdom Radiol (NY), 2017. 42(8): p. 2135-2145.

    Article  Google Scholar 

  27. 27.Tian, W., et al., An evaluation of the clinical diagnostic value of contrast-enhanced ultrasound combined with contrast-enhanced computed tomography in space-occupying lesions of the kidney. Onco Targets Ther, 2017. 10: p. 3493-3499.

    Article  PubMed  PubMed Central  Google Scholar 

  28. 28.Yuan, X., et. al., Comparison of contrast-enhanced ultrasonography and contrast-enhanced computed tomography in the diagnosis of cystic renal cell carcinoma. Int J Clin Exp Med, 2017. 10(7): p. 10820-10826.

    Google Scholar 

  29. 29.Rubenthaler, J., et al., Evaluation of renal lesions using contrast-enhanced ultrasound (CEUS); a 10-year retrospective European single-centre analysis. Eur Radiol, 2018. 28(11): p. 4542-4549.

    Article  PubMed  Google Scholar 

  30. 30.Nicolau, C., et al., Prospective evaluation of CT indeterminate renal masses using US and contrast-enhanced ultrasound. Abdom Imaging, 2015. 40(3): p. 542-51.

    Article  PubMed  Google Scholar 

  31. 31.Bertolotto, M., et al., Renal Masses With Equivocal Enhancement at CT: Characterization With Contrast-Enhanced Ultrasound. AJR Am J Roentgenol, 2015. 204(5): p. W557-65.

    Article  PubMed  Google Scholar 

  32. 32.Chen, Y., et al., Comparison of contrast-enhanced sonography with MRI in the diagnosis of complex cystic renal masses. J Clin Ultrasound, 2015. 43(4): p. 203-209.

    Article  CAS  PubMed  Google Scholar 

  33. 33.Sanz, e., Hevia V., Gomez, V. et. al., Renal complex cystic masses: usefulness of contrast-enhanced ultrasound (CEUS) in their assessment and its agreement with computed tomography. Curr Urol Rep, 2016. 17: p. 89.

    Article  PubMed  Google Scholar 

  34. 34.Yong, C., Y.M. Teo, and K. Jeevesh, Diagnostic performance of contrast-enhanced ultrasound in the evaluation of renal masses in patients with renal impairment. Med J Malaysia, 2016. 71(4): p. 193-198.

    CAS  PubMed  Google Scholar 

  35. 35.Defortescu, G., et al., Diagnostic performance of contrast-enhanced ultrasonography and magnetic resonance imaging for the assessment of complex renal cysts: A prospective study. Int J Urol, 2017. 24(3): p. 184-189.

    Article  PubMed  Google Scholar 

  36. 36.Barr, R.G., Is There a Need to Modify the Bosniak Renal Mass Classification With the Addition of Contrast-Enhanced Sonography? J Ultrasound Med, 2017. 36(5): p. 865-868.

    Article  PubMed  Google Scholar 

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  1. Department of Radiology, Northeastern Ohio Medical University, Rootstown, OH, USA

    Richard G. Barr

  2. Southwoods Imaging, 7623 Market Street, Youngstown, OH, 44512, USA

    Richard G. Barr

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  1. Richard G. Barr
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Correspondence to Richard G. Barr.

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RGB: Research Grants: Siemens Ultrasound, Philips Ultrasound, Samsung Ultrasound, Mindray Ultrasound, GE Medical; Speakers Bureau: Siemens Ultrasound, Philips Ultrasound, Mindray, Canon Medical Systems; Royalties: Thieme Publishers; Advisory Panels: Hologic.

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Barr, R.G. Use of lumason/sonovue in contrast-enhanced ultrasound of the kidney for characterization of renal masses—a meta-analysis. Abdom Radiol 47, 272–287 (2022). https://doi.org/10.1007/s00261-021-03295-2

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