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Open Access 01-12-2017 | Research article

Diagnostic accuracy of contrast-enhanced ultrasound for characterization of kidney lesions in patients with and without chronic kidney disease

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

Published in: BMC Nephrology | Issue 1/2017

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.

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Title: Diagnostic accuracy of contrast-enhanced ultrasound for characterization of kidney lesions in patients with and without chronic kidney disease
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
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Nephrology / Issue 1/2017
Electronic ISSN: 1471-2369
DOI: https://doi.org/10.1186/s12882-017-0681-8

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Diagnostic accuracy of contrast-enhanced ultrasound for characterization of kidney lesions in patients with and without chronic kidney disease

Abstract

Background

Methods

Results

Conclusions

Trial registration

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Abstract

Background

Methods

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Conclusions

Trial registration

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