Diagnostic Accuracy of Contrast-enhanced Ultrasound for Characterization of Kidney Lesions in Patients with and Without Chronic Kidney Disease

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2017 Aug 11

PMID 28793871

Citations 14

Authors

Emily Hueywen Chang

Wui Kheong Chong

Sandeep Kumar Kasoji

Julia Rose Fielding

Ersan Altun

Lee B Mullin

Jung In Kim

Jason Peter Fine

Paul Alexander Dayton

Wendy Kimryn Rathmell

Affiliations

Soon will be listed here.

Abstract

Background: Patients with chronic kidney disease are at increased risk of cystic kidney disease that requires imaging monitoring in many cases. However, these same patients often have contraindications to contrast-enhanced computed tomography and magnetic resonance imaging. This study evaluates the accuracy of contrast-enhanced ultrasound (CEUS), which is safe for patients with chronic kidney disease, for the characterization of kidney lesions in patients with and without chronic kidney disease.

Methods: We performed CEUS on 44 patients, both with and without chronic kidney disease, with indeterminate or suspicious kidney lesions (both cystic and solid). Two masked radiologists categorized lesions using CEUS images according to contrast-enhanced ultrasound adapted criteria. CEUS designation was compared to histology or follow-up imaging in cases without available tissue in all patients and the subset with chronic kidney disease to determine sensitivity, specificity and overall accuracy.

Results: Across all patients, CEUS had a sensitivity of 96% (95% CI: 84%, 99%) and specificity of 50% (95% CI: 32%, 68%) for detecting malignancy. Among patients with chronic kidney disease, CEUS sensitivity was 90% (95% CI: 56%, 98%), and specificity was 55% (95% CI: 36%, 73%).

Conclusions: CEUS has high sensitivity for identifying malignancy of kidney lesions. However, because specificity is low, modifications to the classification scheme for contrast-enhanced ultrasound could be considered as a way to improve contrast-enhanced ultrasound specificity and thus overall performance. Due to its sensitivity, among patients with chronic kidney disease or other contrast contraindications, CEUS has potential as an imaging test to rule out malignancy.

Trial Registration: This trial was registered in clinicaltrials.gov, NCT01751529 .

Citing Articles

Contrast-enhanced ultrasound of renal masses in the pre-transplant setting: literature review with case highlights.

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The Performance of Flash Replenishment Contrast-Enhanced Ultrasound for the Qualitative Assessment of Kidney Lesions in Patients with Chronic Kidney Disease.

Walmer R, Ritter V, Sridharan A, Kasoji S, Altun E, Lee E J Clin Med. 2023; 12(20).

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The diagnostic value of DMSA scan in differentiating functional pseudo-tumors from malignancies in scarred kidneys: case series and literature review.

Mohammed E, Kaddourah A, Al Khori N, Djekidel M BMC Nephrol. 2023; 24(1):148.

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Classifying Kidney Disease in a Vervet Model Using Spatially Encoded Contrast-Enhanced Ultrasound Perfusion Parameters.

AlHmoud I, Walmer R, Kavanagh K, Chang E, Johnson K, Bikdash M Ultrasound Med Biol. 2022; 49(3):761-772.

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Kidney Ultrasound for Nephrologists: A Review.

Singla R, Kadatz M, Rohling R, Nguan C Kidney Med. 2022; 4(6):100464.

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