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Purpose: The objective of our study was to prospectively evaluate the diagnostic performance of strain elastography for differentiation between renal cell carcinomas (RCCs) and transitional cell carcinomas (TCCs) of kidney., Methods: A total of 99 consecutive patients who were referred to our hospital because of a newly diagnosed solid renal mass suspicious for malignancy on radiological screenings were evaluated with sonography, including strain elastography. Strain elastography was used to compare the stiffness of the renal masses and renal cortex. The ratio of strain in a renal mass and nearby renal cortex was defined as the strain index value. Mean strain index values for RCCs and TCCs were compared, and mean strain index values between histological subtypes of RCC were also compared., Results: Although TCCs were smaller than RCCs (p < 0.001), there were no significant differences in gender distribution and mean age of the patients, and mean probe-tumor distance between RCC and TCC. The mean strain index value ±SD for TCC (5.18 ± 1.12) was significantly higher than the value for RCC (4.04 ± 0.72; p < 0.001). Mean strain index value for papillary cell carcinomas (4.09 ± 0.45) was slightly higher than that for clear cell carcinomas (3.85 ± 0.78): however, the difference was not statistically significant (p = 0.51)., Conclusions: Strain elastography can be used as a valuable imaging technique for preoperative differentiation between RCC and TCC of kidney.

Real-time sonoelastography (RSE) is a relatively new imaging technique that visualizes relative difference in tissue hardness by evaluating changes in local strain in response to external stress. Our aim was to evaluate the ability of investigators to use sonoelastography to detect differences in renal cortical stiffness and assess the relationship between stiffness and clinical-Doppler parameters. In 42 adult renal transplant recipients, sonoelastography of kidney was performed to calculate the strain ratio (SR) of the central echo complex to the renal parenchyma. Resistive index (RI) and pulsatility index (PI) were also measured. Estimated glomerular filtration rate (eGFR) was calculated. Parenchymal stiffness showed significant positive correlation with RI and PI (r: 0.41 p = 0.007 and r: 0.48 p = 0.001, respectively). Parenchymal stiffness and eGFR did not have a significant correlation (p = 0.42). Interobserver agreement, expressed as intraclass correlation coeffiicient was 0.47 (95% CI: 0.05-0.70). Parenchymal stiffness (SR) showed significant positive correlation with RI and PI but sonoelastography has also wide range intra- and low interobserver agreement in renal transplants. Further studies are warranted in larger patient groups to determine the reliability of sonoelastography in renal transplants., (Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)