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Can contrast enhanced ultrasound differentiate benign cystic nephroma from malignant multicystic renal lesions? A case report.

ABSTRACT: Multicystic renal lesions pose a diagnostic dilemma and standard imaging may not be able to differentiate between benign or malignant lesions. Adult cystic nephroma and multicystic renal cell carcinoma are two such cystic renal lesions. We describe the appearance of cystic nephroma using contrast enhanced ultrasound. We hypothesize how quantitative parameters using time intensity curves appear to be able to distinguish between cystic nephroma and other malignant lesions such as multicystic renal cell carcinoma. This differentiation is of importance as it may obviate the need for tissue sampling and allow the clinician to recommend conservative management rather than nephrectomy.

SUBMITTER: Chua N

PROVIDER: S-EPMC6906693 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Can contrast enhanced ultrasound differentiate benign cystic nephroma from malignant multicystic renal lesions? A case report.

Chua Nicholas N Wolfe Konrad K Mehta Sampi S Liyanage Sidath H SH

Urology case reports 20191122

Multicystic renal lesions pose a diagnostic dilemma and standard imaging may not be able to differentiate between benign or malignant lesions. Adult cystic nephroma and multicystic renal cell carcinoma are two such cystic renal lesions. We describe the appearance of cystic nephroma using contrast enhanced ultrasound. We hypothesize how quantitative parameters using time intensity curves appear to be able to distinguish between cystic nephroma and other malignant lesions such as multicystic renal ...[more]

PMID: 31867215

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Project description:The aim of the present study was to assess the performance of contrast-enhanced ultrasound in distinguishing between malignant and benign breast lesions and the diagnostic value of its clinical application. A total of 52 cases with malignant breast tumors and 73 cases with benign breast lesions were included in the study. Time-intensity curves (TICs) for contrast-enhanced ultrasound were recorded, and the perfusion parameters were obtained and analyzed. Typical features of malignant breast tumors included irregular shape and vascular morphology, uneven contrast agent distribution, filling defects and contrast agent retention, 'fast-out' wash-out mode, unclear boundaries and uneven internal echo. Benign lesions were characterized by 'slow-out' or synchronous wash-out mode. Regarding perfusion, the starting time of the perfusion of the Sone-Vue microbubble contrast (always 20-30 sec) and time to peak (TTP) were significantly earlier for the malignant lesions, while the wash-out time was later. A significantly greater peak intensity, rising slope and area under the TIC were observed for the malignant breast lesions. All of the malignant breast lesions exhibited an enlarged focus scope on ultrasound, while no obvious focus scope enhancement was observed for benign breast lesions. Furthermore, the TICs of 88.4% of malignant breast lesions were of the fast-rising and slow-declining type, while the TICs of 75.3 and 17.8% of the benign breast lesions were of the slow-rising and fast-declining, and fast-rising and fast-declining type, respectively. Receiver operating characteristics analysis indicated that the TTP, wash-out time and rising slope might contribute to the differential diagnosis between malignant and benign breast lesions. In conclusion, TIC parameters of contrast-enhanced ultrasound have promising clinical value in differentiating between malignant and benign breast lesions. The TTP, wash-out time and rising slope may contribute to the diagnosis of patients with breast lesions to facilitate timely treatment and prognostication of breast cancer patients.

Project description:Background: We performed a network meta-analysis to compare the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) and shear wave elastography (SWE) in differentiating benign and malignant lesions in different body sites. Methods: A computerized literature search of Medline, Embase, SCOPUS, and Web of Science was performed using relevant keywords. Following data extraction, we calculated sensitivity, specificity, positive likelihood ratio (LR), negative LR, and diagnostic odds ratio (DOR) for CEUS, and SWE compared to histopathology as a reference standard. Statistical analyses were conducted by MetaDiSc (version 1.4) and R software (version 3.4.3). Results: One hundred and fourteen studies (15,926 patients) were pooled in the final analyses. Network meta-analysis showed that CEUS had significantly higher DOR than SWE (DOR = 27.14, 95%CI [2.30, 51.97]) in breast cancer detection. However, there were no significant differences between CEUS and SWE in hepatic (DOR = -6.67, 95%CI [-15.08, 1.74]) and thyroid cancer detection (DOR = 3.79, 95%CI [-3.10, 10.68]). Interestingly, ranking analysis showed that CEUS achieved higher DOR in detecting breast and thyroid cancer, while SWE achieved higher DOR in detecting hepatic cancer. The overall DOR for CEUS in detecting renal cancer was 53.44, 95%CI [29.89, 95.56] with an AUROC of 0.95, while the overall DOR for SWE in detecting prostate cancer was 25.35, 95%CI [7.15, 89.89] with an AUROC of 0.89. Conclusion: Both diagnostic tests showed relatively high sensitivity and specificity in detecting malignant tumors in different organs. Network meta-analysis showed that CEUS had higher diagnostic accuracy than SWE in detecting breast and thyroid cancer, while SWE had higher accuracy in detecting hepatic cancer. However, the results were not statistically significant in hepatic and thyroid malignancies. Further head-to-head comparisons are needed to confirm the optimal imaging technique to differentiate each cancer type.

Dataset Information

Can contrast enhanced ultrasound differentiate benign cystic nephroma from malignant multicystic renal lesions? A case report.

Publications

Can contrast enhanced ultrasound differentiate benign cystic nephroma from malignant multicystic renal lesions? A case report.

Similar Datasets

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