Usefulness of contrast-enhanced ultrasonography for diagnosis of renal cell carcinoma in dialysis patients: Comparison with computed tomography

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Abstract

AIMS: To investigate the usefulness of contrast-enhanced ultrasonography for diagnosing renal cell carcinoma (RCC) in dialysis patients. MATERIAL AND METHODS: Of 1301 dialysis patients who underwent abdominal computed tomography (CT) between January 2012 and March 2017, 19 were suspected to have solid renal lesions; of these patients, 18 gave consent for and underwent contrast-enhanced ultrasonography with perflubutane in addition to CT; 13 underwent dynamic contrast-enhanced CT, and 5, who could not be administered iodinated contrast media, underwent unenhanced CT. The final diagnoses were based on histopathological findings or the presence/absence of enlargement of the lesion during follow-up. RESULTS: Of the 19 lesions in 18 patients, 14 were diagnosed as RCC and 5 as benign cysts. CT facilitated accurate diagnosis in 10/19 lesions (52.6%) with obvious enhancement (≥20 Hounsfield units [HU]), while definitive diagnosis by CT was difficult in 9 lesions: 2 lesions showed ambiguous enhancement (10-20 HU), 1 lesion was an inflammatory cyst with obvious enhancement, and 6 lesions were assessed by unenhanced CT. Compared with CT, contrast-enhanced ultrasonography allowed more accurate diagnosis (McNemar test, P = .02) in 17/19 lesions (89.5%, 14 RCC and 3 cysts; including all lesions assessed by unenhanced CT and 2 with ambiguous enhancement on CT), with 1 false-positive (inflammatory cyst with hyper-enhancement) and 1 false-negative result due to deep location of the lesion. CONCLUSIONS: Contrast-enhanced ultrasonography was useful for the diagnosis of RCC in dialysis patients with suspected solid renal lesions especially when contrast enhancement was not obvious on CT or contrast-enhanced CT could not be performed.

Original languageEnglish
Pages (from-to)e18053
JournalMedicine
Volume98
Issue number47
DOIs
Publication statusPublished - 2019 Nov 1

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Renal Cell Carcinoma
Dialysis
Ultrasonography
Tomography
Cysts
Kidney
Contrast Media

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{d4a88879743741c4a164373f1d16cb6b,
title = "Usefulness of contrast-enhanced ultrasonography for diagnosis of renal cell carcinoma in dialysis patients: Comparison with computed tomography",
abstract = "AIMS: To investigate the usefulness of contrast-enhanced ultrasonography for diagnosing renal cell carcinoma (RCC) in dialysis patients. MATERIAL AND METHODS: Of 1301 dialysis patients who underwent abdominal computed tomography (CT) between January 2012 and March 2017, 19 were suspected to have solid renal lesions; of these patients, 18 gave consent for and underwent contrast-enhanced ultrasonography with perflubutane in addition to CT; 13 underwent dynamic contrast-enhanced CT, and 5, who could not be administered iodinated contrast media, underwent unenhanced CT. The final diagnoses were based on histopathological findings or the presence/absence of enlargement of the lesion during follow-up. RESULTS: Of the 19 lesions in 18 patients, 14 were diagnosed as RCC and 5 as benign cysts. CT facilitated accurate diagnosis in 10/19 lesions (52.6{\%}) with obvious enhancement (≥20 Hounsfield units [HU]), while definitive diagnosis by CT was difficult in 9 lesions: 2 lesions showed ambiguous enhancement (10-20 HU), 1 lesion was an inflammatory cyst with obvious enhancement, and 6 lesions were assessed by unenhanced CT. Compared with CT, contrast-enhanced ultrasonography allowed more accurate diagnosis (McNemar test, P = .02) in 17/19 lesions (89.5{\%}, 14 RCC and 3 cysts; including all lesions assessed by unenhanced CT and 2 with ambiguous enhancement on CT), with 1 false-positive (inflammatory cyst with hyper-enhancement) and 1 false-negative result due to deep location of the lesion. CONCLUSIONS: Contrast-enhanced ultrasonography was useful for the diagnosis of RCC in dialysis patients with suspected solid renal lesions especially when contrast enhancement was not obvious on CT or contrast-enhanced CT could not be performed.",
author = "Masahiro Hashimoto and Kiyoshi Ohkuma and Hirotaka Akita and Yoshitake Yamada and Seishi Nakatsuka and Ryuichi Mizuno and Mototsugu Oya and Masahiro Jinzaki",
year = "2019",
month = "11",
day = "1",
doi = "10.1097/MD.0000000000018053",
language = "English",
volume = "98",
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number = "47",

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TY - JOUR

T1 - Usefulness of contrast-enhanced ultrasonography for diagnosis of renal cell carcinoma in dialysis patients

T2 - Comparison with computed tomography

AU - Hashimoto, Masahiro

AU - Ohkuma, Kiyoshi

AU - Akita, Hirotaka

AU - Yamada, Yoshitake

AU - Nakatsuka, Seishi

AU - Mizuno, Ryuichi

AU - Oya, Mototsugu

AU - Jinzaki, Masahiro

PY - 2019/11/1

Y1 - 2019/11/1

N2 - AIMS: To investigate the usefulness of contrast-enhanced ultrasonography for diagnosing renal cell carcinoma (RCC) in dialysis patients. MATERIAL AND METHODS: Of 1301 dialysis patients who underwent abdominal computed tomography (CT) between January 2012 and March 2017, 19 were suspected to have solid renal lesions; of these patients, 18 gave consent for and underwent contrast-enhanced ultrasonography with perflubutane in addition to CT; 13 underwent dynamic contrast-enhanced CT, and 5, who could not be administered iodinated contrast media, underwent unenhanced CT. The final diagnoses were based on histopathological findings or the presence/absence of enlargement of the lesion during follow-up. RESULTS: Of the 19 lesions in 18 patients, 14 were diagnosed as RCC and 5 as benign cysts. CT facilitated accurate diagnosis in 10/19 lesions (52.6%) with obvious enhancement (≥20 Hounsfield units [HU]), while definitive diagnosis by CT was difficult in 9 lesions: 2 lesions showed ambiguous enhancement (10-20 HU), 1 lesion was an inflammatory cyst with obvious enhancement, and 6 lesions were assessed by unenhanced CT. Compared with CT, contrast-enhanced ultrasonography allowed more accurate diagnosis (McNemar test, P = .02) in 17/19 lesions (89.5%, 14 RCC and 3 cysts; including all lesions assessed by unenhanced CT and 2 with ambiguous enhancement on CT), with 1 false-positive (inflammatory cyst with hyper-enhancement) and 1 false-negative result due to deep location of the lesion. CONCLUSIONS: Contrast-enhanced ultrasonography was useful for the diagnosis of RCC in dialysis patients with suspected solid renal lesions especially when contrast enhancement was not obvious on CT or contrast-enhanced CT could not be performed.

AB - AIMS: To investigate the usefulness of contrast-enhanced ultrasonography for diagnosing renal cell carcinoma (RCC) in dialysis patients. MATERIAL AND METHODS: Of 1301 dialysis patients who underwent abdominal computed tomography (CT) between January 2012 and March 2017, 19 were suspected to have solid renal lesions; of these patients, 18 gave consent for and underwent contrast-enhanced ultrasonography with perflubutane in addition to CT; 13 underwent dynamic contrast-enhanced CT, and 5, who could not be administered iodinated contrast media, underwent unenhanced CT. The final diagnoses were based on histopathological findings or the presence/absence of enlargement of the lesion during follow-up. RESULTS: Of the 19 lesions in 18 patients, 14 were diagnosed as RCC and 5 as benign cysts. CT facilitated accurate diagnosis in 10/19 lesions (52.6%) with obvious enhancement (≥20 Hounsfield units [HU]), while definitive diagnosis by CT was difficult in 9 lesions: 2 lesions showed ambiguous enhancement (10-20 HU), 1 lesion was an inflammatory cyst with obvious enhancement, and 6 lesions were assessed by unenhanced CT. Compared with CT, contrast-enhanced ultrasonography allowed more accurate diagnosis (McNemar test, P = .02) in 17/19 lesions (89.5%, 14 RCC and 3 cysts; including all lesions assessed by unenhanced CT and 2 with ambiguous enhancement on CT), with 1 false-positive (inflammatory cyst with hyper-enhancement) and 1 false-negative result due to deep location of the lesion. CONCLUSIONS: Contrast-enhanced ultrasonography was useful for the diagnosis of RCC in dialysis patients with suspected solid renal lesions especially when contrast enhancement was not obvious on CT or contrast-enhanced CT could not be performed.

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DO - 10.1097/MD.0000000000018053

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SP - e18053

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

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