TY - JOUR
T1 - Expanding the Role of Ultrasound for the Characterization of Renal Masses
AU - on behalf of the European Association of Urology (EAU) Young Academic Urologists (YAU) Renal Cancer Working Group
AU - Roussel, Eduard
AU - Campi, Riccardo
AU - Amparore, Daniele
AU - Bertolo, Riccardo
AU - Carbonara, Umberto
AU - Erdem, Selcuk
AU - Ingels, Alexandre
AU - Kara, Önder
AU - Marandino, Laura
AU - Marchioni, Michele
AU - Muselaers, Stijn
AU - Pavan, Nicola
AU - Pecoraro, Angela
AU - Beuselinck, Benoit
AU - Pedrosa, Ivan
AU - Fetzer, David
AU - Albersen, Maarten
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Background The incidental detection of renal masses has been steadily rising. As a significant proportion of renal masses that are surgically treated are benign or indolent in nature, there is a clear need for better presurgical characterization of renal masses to minimize unnecessary harm. Ultrasound is a widely available and relatively inexpensive real-time imaging technique, and novel ultrasound-based applications can potentially aid in the non-invasive characterization of renal masses. Evidence acquisition: We performed a narrative review on novel ultrasound-based techniques that can aid in the non-invasive characterization of renal masses. Evidence synthesis: Contrast-enhanced ultrasound (CEUS) adds significant diagnostic value, particularly for cystic renal masses, by improving the characterization of fine septations and small nodules, with a sensitivity and specificity comparable to magnetic resonance imaging (MRI). Additionally, the performance of CEUS for the classification of benign versus malignant renal masses is comparable to that of computed tomography (CT) and MRI, although the imaging features of different tumor subtypes overlap significantly. Ultrasound molecular imaging with targeted contrast agents is being investigated in preclinical research as an addition to CEUS. Elastography for the assessment of tissue stiffness and micro-Doppler imaging for the improved detection of intratumoral blood flow without the need for contrast are both being investigated for the characterization of renal masses, though few studies have been conducted and validation is lacking. Conclusions: Several novel ultrasound-based techniques have been investigated for the non-invasive characterization of renal masses. CEUS has several advantages over traditional grayscale ultrasound, including the improved characterization of cystic renal masses and the potential to differentiate benign from malignant renal masses to some extent. Ultrasound molecular imaging offers promise for serial disease monitoring and the longitudinal assessment of treatment response, though this remains in the preclinical stages of development. While elastography and emerging micro-Doppler techniques have shown some encouraging applications, they are currently not ready for widespread clinical use.
AB - Background The incidental detection of renal masses has been steadily rising. As a significant proportion of renal masses that are surgically treated are benign or indolent in nature, there is a clear need for better presurgical characterization of renal masses to minimize unnecessary harm. Ultrasound is a widely available and relatively inexpensive real-time imaging technique, and novel ultrasound-based applications can potentially aid in the non-invasive characterization of renal masses. Evidence acquisition: We performed a narrative review on novel ultrasound-based techniques that can aid in the non-invasive characterization of renal masses. Evidence synthesis: Contrast-enhanced ultrasound (CEUS) adds significant diagnostic value, particularly for cystic renal masses, by improving the characterization of fine septations and small nodules, with a sensitivity and specificity comparable to magnetic resonance imaging (MRI). Additionally, the performance of CEUS for the classification of benign versus malignant renal masses is comparable to that of computed tomography (CT) and MRI, although the imaging features of different tumor subtypes overlap significantly. Ultrasound molecular imaging with targeted contrast agents is being investigated in preclinical research as an addition to CEUS. Elastography for the assessment of tissue stiffness and micro-Doppler imaging for the improved detection of intratumoral blood flow without the need for contrast are both being investigated for the characterization of renal masses, though few studies have been conducted and validation is lacking. Conclusions: Several novel ultrasound-based techniques have been investigated for the non-invasive characterization of renal masses. CEUS has several advantages over traditional grayscale ultrasound, including the improved characterization of cystic renal masses and the potential to differentiate benign from malignant renal masses to some extent. Ultrasound molecular imaging offers promise for serial disease monitoring and the longitudinal assessment of treatment response, though this remains in the preclinical stages of development. While elastography and emerging micro-Doppler techniques have shown some encouraging applications, they are currently not ready for widespread clinical use.
KW - Contrast-enhanced ultrasound
KW - Micro-Doppler
KW - Molecular ultrasound
KW - Renal cell carcinoma
KW - Renal mass
KW - Renal tumor
KW - Ultrasonography
KW - Ultrasound
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U2 - 10.3390/jcm11041112
DO - 10.3390/jcm11041112
M3 - Review article
C2 - 35207384
AN - SCOPUS:85124979848
SN - 2077-0383
VL - 11
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 4
M1 - 1112
ER -