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

BMC Nephrology

Research Article

Jason Peter Fine¹  Jung In Kim¹  Ersan Altun²  Wui Kheong Chong³  Paul Alexander Dayton⁴  Sandeep Kumar Kasoji⁴  Lee B. Mullin⁴  Wendy Kimryn Rathmell⁵  Julia Rose Fielding⁶  Emily Hueywen Chang⁷ 

[1] Department of Biostatistics, University of North Carolina, 3101 McGavran-Greenberg Hall, CB #7420, 27599-7420, Chapel Hill, NC, USA;Department of Radiology, University of North Carolina at Chapel Hill, CB 7510, 27599, Chapel Hill, NC, USA;Diagnostic Radiology, Abdominal Imaging Section, The University of Texas MD Anderson Cancer Center, Unit 1473 FCT15.5092, 1400 Pressler Street, 77030, Houston, TX, USA;Department of Radiology, University of North Carolina at Chapel Hill, CB 7510, 27599, Chapel Hill, NC, USA;Joint Biomedical Engineering Department, University of North Carolina at Chapel Hill/NCSU, CB 7575, 27599, Chapel Hill, NC, USA;Present address: Department of Medicine, Division of Hematology and Oncology, Vanderbilt University, 777 Preston Research Building, 37232, Nashville, TN, USA;University of North Carolina, Lineberger Cancer Center, NC 27599, Chapel Hill, USA;Present address: University of Texas Southwestern at Dallas, 5323 Harry Hines Boulevard, 75390-8827, Dallas, TX, USA;Department of Radiology, University of North Carolina at Chapel Hill, CB 7510, 27599, Chapel Hill, NC, USA;University of North Carolina, 7024 Burnett Womack, CB 7155, 27599, Chapel Hill, NC, USA;

关键词: Contrast;    Ultrasound;    Contrast-enhanced ultrasound;    Kidney;    Kidney lesion;    Chronic kidney disease;   

DOI  :  10.1186/s12882-017-0681-8

 received in 2017-05-01, accepted in 2017-07-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPatients 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.MethodsWe 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.ResultsAcross 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%).ConclusionsCEUS 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 registrationThis trial was registered in clinicaltrials.gov, NCT01751529.

【 授权许可】

CC BY   
© The Author(s). 2017