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Diagnostic accuracy of contrast-enhanced ultrasound for characterization of kidney lesions in patients with and without chronic kidney disease
- Source :
- BMC Nephrology, Vol 18, Iss 1, Pp 1-13 (2017), BMC Nephrology
- Publication Year :
- 2017
- Publisher :
- BMC, 2017.
-
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. Electronic supplementary material The online version of this article (doi:10.1186/s12882-017-0681-8) contains supplementary material, which is available to authorized users.
- Subjects :
- Nephrology
Adult
Male
medicine.medical_specialty
Kidney lesion
Contrast Media
Pilot Projects
Malignancy
Kidney
lcsh:RC870-923
030218 nuclear medicine & medical imaging
03 medical and health sciences
Cystic kidney disease
0302 clinical medicine
Internal medicine
Chronic kidney disease
Ultrasound
medicine
Humans
Prospective Studies
Renal Insufficiency, Chronic
Aged
Ultrasonography
medicine.diagnostic_test
business.industry
Magnetic resonance imaging
Middle Aged
Contrast
medicine.disease
lcsh:Diseases of the genitourinary system. Urology
3. Good health
medicine.anatomical_structure
030220 oncology & carcinogenesis
Female
Radiology
business
Contrast-enhanced ultrasound
Kidney disease
Research Article
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 14712369
- Volume :
- 18
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Nephrology
- Accession number :
- edsair.doi.dedup.....27b23109dc8da32cb2c23891f1557592