title: Comparison of magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in the evaluation of unclear solid renal lesions.
abstract: OBJECTIVE
  To compare the sensitivity and specificity of contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) in the evaluation of unclear renal lesions to the histopathological outcome.
  
  
  METHODS
  A total of 36 patients with a single unclear solid renal lesion with initial imaging studies between 2005 and 2015 were included. CEUS and MRI were used for determining malignancy or benignancy and initial findings were correlated with the histopathological outcome. Out of the 36 renal masses a total of 28 lesions were malignant (77.8%) and 8 were found to be benign (22.2%). Diagnostic accuracy was testes by using the histopathological diagnosis as the gold standard.
  
  
  RESULTS
  CEUS showed a sensitivity of 96.4%, a specificity of 100.0%, a positive predictive value (PPV) of 100.0% and a negative predictive value (NPV) of 88,9%. MRI showed a sensitivity of 96.4%, a specificity of 75.0%, a PPV of 93.1% and a NPV of 85.7%. Out of the 28 malignant lesions a total of 18 clear cell renal carcinomas, 6 papillary renal cell carcinomas and 4 other malignant lesions, e.g. metastases, were diagnosed. Out of the 8 benign lesions a total 3 angiomyolipomas, 2 oncocytomas, 1 benign renal cyst and 2 other benign lesions, e.g. renal adenomas were diagnosed. Using CEUS, 1 lesion was falsely identified as benign. Using MRI, 2 lesions were falsely identified as benign and 1 lesion was falsely identified as malignant.
  
  
  CONCLUSIONS
  CEUS is an useful method which can be additionally used to clinically differentiate between malignant and benign renal lesions. CEUS shows a comparable sensitivity, specificity, PPV and NPV to MRI. In daily clinical routine, patients with contraindications for other imaging modalities can particularly benefit using this method.
authors: Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany.
authors: J
authors: J
authors: Rübenthaler
authors: Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany.
authors: K
authors: K
authors: Paprottka
authors: Department of Urology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany.
authors: J
authors: J
authors: Marcon
authors: Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany.
authors: E
authors: E
authors: Hameister
authors: Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany.
authors: K
authors: K
authors: Hoffmann
authors: Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany.
authors: N
authors: N
authors: Joiko
authors: Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany.
authors: M
authors: M
authors: Reiser
authors: Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany.
authors: D A
authors: DA
authors: Clevert
mesh_terms: D002292:Carcinoma, Renal Cell; D003287:Contrast Media / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Contrast-enhanced ultrasound (CEUS); magnetic resonance imaging (MRI); solid renal lesions