Diagnostic Accuracy of Contrast-Enhanced Ultrasonography for the Assessment of Small Renal Mass: A Prospective Study
10.22465/juo.244800320016
- Author:
Jae-Wook CHUNG
1
;
Seo Young PARK
;
Seunghee WOO
;
Yun Ah KIM
;
Jun-Koo KANG
;
Yun-Sok HA
;
Jun Nyung LEE
;
Bum Soo KIM
;
Tae-Hwan KIM
;
Ghil Suk YOON
;
Tae Gyun KWON
;
See Hyung KIM
Author Information
1. Department of Urology, Kyungpook National University Hospital, Daegu, Korea
- Publication Type:Original Article
- From:
Journal of Urologic Oncology
2024;22(2):128-135
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:We prospectively compared the diagnostic accuracy of kidney dynamic computed tomography (KDCT), magnetic resonance imaging (MRI), and contrast-enhanced ultrasonography (CEUS) for the assessment of small renal mass (SRM) (≤4 cm).
Materials and Methods:Seventy-six patients with SRM (mean age, 58.4±13.1 years) who underwent renal biopsy (n=11) or nephrectomy (partial or radical) (n=65) were enrolled. All patients underwent KDCT, MRI, and CEUS before renal biopsy or nephrectomy.
Results:The mean maximal tumor size was 21.0±9.8 mm. The mean R.E.N.A.L nephrometry score was 7.0±1.7. Fifty-six patients had renal cell carcinoma (RCC) (clear cell, 42; papillary, 7; chromophobe, 5; succinate dehydrogenase deficient, 1; unspecified RCC, 1). Twenty patients had a benign tumor (angiomyolipoma, 11; oncocytoma, 3; others, 6). Clinicopathologic variables were comparable in RCC and benign groups. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of KDCT were 89.3%, 10.0%, 73.5%, and 25.0%, respectively. The sensitivity, specificity, PPV, and NPV of MRI were 89.3%, 10.0%, 73.5%, and 25.0%, respectively. The sensitivity, specificity, PPV, and NPV of CEUS were 85.7%, 50.0%, 82.8%, and 55.6%, respectively. The diagnostic accuracy of KDCT, MRI, and CEUS were 68.4%, 68.4%, and 76.3%, respectively. In a subgroup analysis based on clinical tumor size of 10 mm and 20 mm, CEUS also showed the highest diagnostic accuracy.
Conclusions:CEUS had the highest specificity, PPV, and NPV and may help improve the assessment of SRM.
