CEUS in diagnosis of renal masses
DOI:
https://doi.org/10.12775/JEHS.2024.68.51227Keywords
ultrasonography, cotrast enhanced ultrasonography, kidneys, renal massesAbstract
Introduction and purpose
Contrast enhanced ultrasound (CEUS) is a modern diagnostic method that uses ultrasound waves in combination with intravenous administration of a contrast agent. It enables obtaining high resolution and assessing microcirculation in real time, thanks to which the researcher is able to analyze the enhancement and its features, which may help in diagnosing a specific pathology. Contrast agents, similar to CT and MRI, show specific phases of enhancement after administration - arterial, venous, delayed. Their additional advantage is safety, especially for patients with impaired kidney and thyroid function, and causing fewer allergic reactions. The aim of this review is to present the CEUS examination technique and the latest reports in the field of diagnosis of renal lesions.
Material and methods
This review was prepared based on the literature available from recent years
in the PubMed and Google Scholar scientific databases using the keywords: ultrasonography, contrast enhanced ultrasonography, kidney, renal masses.
Results
Studies show that CEUS can be an effective method for imaging both cystic and solid lesions in the kidney. When using a contrast agent, the lesions show characteristic features that can guide the investigator to the diagnosis. Moreover, in comparative analyses, CEUS achieved comparable or better results than other diagnostic imaging methods.
Conclusions
CEUS is a modern and promising diagnostic method that can successfully compete with CT and MRI. Moreover, the metabolism and pharmacokinetics of contrast agents and their safety mean that CEUS can be used for the diagnosis of unclear pathologies in elderly patients, as well as for the control and supervision of changes that require frequent imaging. Keywords: ultrasonography, contrast enhanced ultrasonography, kidneys, renal masses
References
Jung EM, Weber MA, Wiesinger I. Contrast-enhanced ultrasound perfusion imaging of organs. Radiologists. 2021 Dec;61(Suppl 1):19-28.
doi: 10.1007/s00117-021-00891-7.
https://radiopaedia.org/articles/contrast-enhanced-ultrasound-2?lang=us
(access 05/05/2024)
Beckmann S, Simanowski JH. Update in Contrast-Enhanced Ultrasound. Visc Med. 2020 Dec;36(6):476-486.
doi: 10.1159/000511352.
Rafailidis V, Huang DY, Yusuf GT, Sidhu PS. General principles and overview of vascular contrast-enhanced ultrasonography. Ultrasonography. 2020 Jan;39(1):22-42. doi: 10.14366/usg.19022.
Granata A, Campo I, Lentini P, Pesce F, Gesualdo L, Basile A, Cantisani V, Zeiler M, Bertolotto M. Role of Contrast-Enhanced Ultrasound (CEUS) in Native Kidney Pathology: Limits and Fields of Action. Diagnostics (Basel). 2021 Jun 8;11(6):1058. doi: 10.3390/diagnostics11061058.
Schwarze V, Marschner C, Negrão de Figueiredo G, Rübenthaler J, Clevert DA. Single-Center Study: Evaluating the Diagnostic Performance and Safety of Contrast-Enhanced Ultrasound (CEUS) in Pregnant Women to Assess Hepatic Lesions. Ultraschall Med. 2020 Feb;41(1):29-35. English.
doi: 10.1055/a-0973-8517.
Lee JY, Minami Y, Choi BI, Lee WJ, Chou YH, Jeong WK, Park MS, Kudo N, Lee MW, Kamata K, Iijima H, Kim SY, Numata K, Sugimoto K, Maruyama H, Sumino Y, Ogawa C , Kitano M, Joo I, Arita J, Liang JD, Lin HM, Nolsoe C, Gilja OH, Kudo M. The AFSUMB Consensus Statements and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound using Sonazoid. JMed Ultrasound. 2020 May 25;28(2):59-82.
doi: 10.4103/JMU.JMU_124_19.
Ajmal S. Contrast-Enhanced Ultrasonography: Review and Applications. Cureus. 2021 Sep 24;13(9):e18243.
doi: 10.7759/cureus.18243.
Malone CD, Fetzer DT, Monsky WL, Itani M, Mellnick VM, Velez PA, Middleton WD, Averkiou MA, Ramaswamy RS. Contrast-enhanced US for the Interventional Radiologist: Current and Emerging Applications. Radiographics. 2020 Mar-Apr;40(2):562-588.
doi: 10.1148/rg.2020190183.
Como G, Da Re J, Adani GL, Zuiani C, Girometti R. Role for contrast-enhanced ultrasound in assessing complications after kidney transplantation. World J Radiol. 2020 Aug 28;12(8):156-171.
doi: 10.4329/wjr.v12.i8.156.
Nicolau C, Antunes N, Paño B, Sebastia C. Imaging Characterization of Renal Masses. Medicina (Kaunas). 2021 Jan 8;57(1):51.
doi: 10.3390/medicina57010051.
Möller K, Jenssen C, Correas JM, Safai Zadeh E, Bertolotto M, Ignee A, Dong Y, Cantisani V, Dietrich CF. CEUS Bosniak Classification-Time for Differentiation and Change in Renal Cyst Surveillance. Cancers (Basel). 2023 Sep 25;15(19):4709.
doi: 10.3390/cancers15194709.
Silverman SG, Pedrosa I, Ellis JH, Hindman NM, Schieda N, Smith AD, Remer EM, Shinagare AB, Curci NE, Raman SS, Wells SA, Kaffenberger SD, Wang ZJ, Chandarana H, Davenport MS. Bosniak Classification of Cystic Renal Masses, Version 2019: An Update Proposal and Needs Assessment. Radiology. 2019 Aug;292(2):475-488.
doi: 10.1148/radiol.2019182646.
Lucocq J, Pillai S, Oparka R, Nabi G. Complex Renal Cysts (Bosniak ≥ IIF): Outcomes in a Population-Based Cohort Study. Cancers (Basel). 2020 Sep 8;12(9):2549.
doi: 10.3390/cancers12092549.
Lucocq J, Pillai S, Oparka R, Nabi G. Complex renal cysts (Bosniak ≥IIF): interobserver agreement, progression and malignancy rates. Eur Radiol. 2021 Feb;31(2):901-908.
doi: 10.1007/s00330-020-07186-w.
Rübenthaler J, Čečatka S, Froelich MF, Stechele M, Marschner C, Sabel BO, Bogner F, Schnitzer ML, Overhoff D, Große Hokamp N, Staehler M, Schwarze V, Clevert DA. Contrast-Enhanced Ultrasound (CEUS) for Follow-Up of Bosniak 2F Complex Renal Cystic Lesions-A 12-Year Retrospective Study in a Specialized European Center. Cancers (Basel). 2020 Aug 4;12(8):2170.
doi: 10.3390/cancers12082170.
Cantisani V, Bertolotto M, Clevert DA, Correas JM, Drudi FM, Fischer T, Gilja OH, Granata A, Graumann O, Harvey CJ, Ignee A, Jenssen C, Lerchbaumer MH, Ragel M, Saftoiu A, Serra AL, Stock KF , Webb J, Sidhu PS. EFSUMB 2020 Proposal for a Contrast-Enhanced Ultrasound-Adapted Bosniak Cyst Categorization - Position Statement. Ultraschall Med. 2021 Apr;42(2):154-166. English.
doi: 10.1055/a-1300-1727.
Herms E, Weirich G, Maurer T, Wagenpfeil S, Preuss S, Sauter A, Heck M, Gärtner A, Hauner K, Autenrieth M, Kübler HP, Holzapfel K, Schwarz-Boeger U, Heemann U, Slotta-Huspenina J, Stock KF. Ultrasound-based "CEUS-Bosniak" classification for cystic renal lesions: an 8-year clinical experience. World J Urol. 2023 Mar;41(3):679-685.
doi: 10.1007/s00345-022-04094-0.
Schwarze V, Rübenthaler J, Čečatka S, Marschner C, Froelich MF, Sabel BO, Staehler M, Knösel T, Geyer T, Clevert DA. Contrast-Enhanced Ultrasound (CEUS) for the Evaluation of Bosniak III Complex Renal Cystic Lesions-A 10-Year Specialized European Single-Center Experience with Histopathological Validation. Medicina (Kaunas). 2020 Dec 12;56(12):692.
doi: 10.3390/medicina56120692.
Münch F, Silivasan EIE, Spiesecke P, Göhler F, Galbavy Z, Eckardt KU, Hamm B, Fischer T, Lerchbaumer MH. Intra- and Interobserver Study Investigating the Adapted EFSUMB Bosniak Cyst Categorization Proposed for Contrast-Enhanced Ultrasound (CEUS) in 2020. Ultraschall Med. 2024 Feb;45(1):47-53. English.
doi: 10.1055/a-2048-6383.
Angelini L, Gioulis E, Civitareale N, Granata A, Zanza C, Longhitano Y, Zago A, Machin P, Canal F, Serao A, Piccoli G, Valerio S. Assessment of Contrast-Enhanced Ultrasound (CEUS) and Computed Tomography (CT ) diagnostic accuracy in the evaluation of challenging cystic renal masses. JUltrasound. 2022 Dec;25(4):905-913. doi:10.1007/s40477-022-00683-2.
Ljungberg B, Albiges L, Abu-Ghanem Y, Bedke J, Capitanio U, Dabestani S, Fernández-Pello S, Giles RH, Hofmann F, Hora M, Klatte T, Kuusk T, Lam TB, Marconi L, Powles T, Tahbaz R, Volpe A, Bex A. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2022 Update. Euro Urol. 2022 Oct;82(4):399-410.
doi: 10.1016/j.eururo.2022.03.006.
Li J, Huang X, Wang L, Wang X, Li Y, Liu X, Ye N, Yang S, Nie F. Role of Contrast-Enhanced Ultrasound With the Enhancement Pattern and Qualitative Analysis for Differentiating Hypovascular Solid Renal Lesions. Ultrasound Med Biol. 2024 Feb;50(2):295-303.
doi: 10.1016/j.ultrasmedbio.2023.11.002.
Tufano A, Drudi FM, Angelini F, Polito E, Martino M, Granata A, Di Pierro GB, Kutrolli E, Sampalmieri M, Canale V, Flammia RS, Fresilli D, Bertolotto M, Leonardo C, Franco G, Cantisani V. Contrast -Enhanced Ultrasound (CEUS) in the Evaluation of Renal Masses with Histopathological Validation-Results from a Prospective Single-Center Study. Diagnostics (Basel). 2022 May 12;12(5):1209.
doi: 10.3390/diagnostics12051209.
Najafi A, Wildt M, Hainc N, Hohmann J. Evaluation of Cystic and Solid Renal Lesions with Contrast-Enhanced Ultrasound: A Retrospective Study. Ultrasound Int Open. 2021 Apr;7(1):E25-E34.
doi: 10.1055/a-1522-8969.
Tufano A, Antonelli L, Di Pierro GB, Flammia RS, Minelli R, Anceschi U, Leonardo C, Franco G, Drudi FM, Cantisani V. Diagnostic Performance of Contrast-Enhanced Ultrasound in the Evaluation of Small Renal Masses: A Systematic Review and Meta-Analysis. Diagnostics (Basel). 2022 Sep 25;12(10):2310.
doi: 10.3390/diagnostics12102310.
Zhu J, Li N, Zhao P, Wang Y, Song Q, Song L, Li Q, Luo Y. Contrast-enhanced ultrasound (CEUS) of benign and malignant renal tumors: Distinguishing CEUS features differ with tumor size. Cancer Med. 2023 Feb;12(3):2551-2559.
doi: 10.1002/cam4.5101.
Tao L, Fan J, Zhan W, Li W, Lu J, Yang N, Ma B, Zhou W. Contrast-enhanced ultrasound manifestations of renal masses undetectable on conventional ultrasound. Front Oncol. 2022 Jul 25;12:943960.
doi: 10.3389/fonc.2022.943960.
Marschner CA, Ruebenthaler J, Schwarze V, Negrão de Figueiredo G, Zhang L, Clevert DA. Comparison of computed tomography (CT), magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in the evaluation of unclear renal lesions. Rofo. 2020 Nov;192(11):1053-1059. English, German.
doi: 10.1055/a-1127-3371.
Furrer MA, Spycher SCJ, Büttiker SM, Gross T, Bosshard P, Thalmann GN, Schneider MP, Roth B. Comparison of the Diagnostic Performance of Contrast-enhanced Ultrasound with That of Contrast-enhanced Computed Tomography and Contrast-enhanced Magnetic Resonance Imaging in the Evaluation of Renal Masses: A Systematic Review and Meta-analysis. Eur Urol Oncol. 2020 Aug;3(4):464-473. doi: 10.1016/j.euo.2019.08.013.
Runtemund J, Rübenthaler J, von Münchhausen N, Ingenerf M, Grawe F, Biechele G, Gassert FG, Tollens F, Rink J, Cecatka S, Schmid-Tannwald C, Froelich MF, Clevert DA, Schnitzer ML. Diagnostic Workup for Patients with Solid Renal Masses: A Cost-Effectiveness Analysis. Cancers (Basel). 2022 Apr 29;14(9):2235.
doi: 10.3390/cancers14092235.
Gassert F, Schnitzer M, Kim SH, Kunz WG, Ernst BP, Clevert DA, Nörenberg D, Rübenthaler J, Froelich MF. Comparison of Magnetic Resonance Imaging and Contrast-Enhanced Ultrasound as Diagnostic Options for Unclear Cystic Renal Lesions: A Cost-Effectiveness Analysis. Ultraschall Med. 2021 Aug;42(4):411-417. English.
doi: 10.1055/a-1110-7172.
Oh A, Bhardwaj L, Cacciamani G, Desai MM, Duddalwar VA. Cost-effectiveness of Contrast-Enhanced Ultrasound for Diagnosis and Active Surveillance of Complex Cystic Renal Lesions. Urol Pract. 2023 Jan;10(1):11-19.
doi: 10.1097/upj.0000000000000354.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Łukasz Ochyra, Anna Łopuszyńska

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 193
Number of citations: 0