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Mahyar Kashan, Mazyar Ghanaat, Andreas M Hötker, Cihan Duzgol, Alejandro Sanchez, Renzo G DiNatale, Kyle A Blum, Maria Becerra, Brandon J Manley, Jozefina Casuscelli, Michael Chiok, Jonathan A Coleman, Paul Russo, Satish K Tickoo, Oguz Akin, A Ari Hakimi
PURPOSE: To evaluate the outcomes of surgical intervention and active surveillance in patients diagnosed with cystic renal cell carcinoma at our hypothesized radiologic cutoff of >50% cystic. MATERIALS AND METHODS: We identified all patients with a pathologically confirmed cystic renal mass that fit our criteria from 2000 to 2015 (n=430). Patients with lack of CT imaging, tumors <50% cystic on imaging, multifocal tumors and prior renal cell carcinoma were excluded (n=292)...
February 26, 2018: Journal of Urology
Cameron Jonathan Lam, Anil Kapoor
INTRODUCTION: We sought to evaluate the pathological results of renal masses in comparison with Bosniak III renal cystic lesions to determine the actual malignancy risk. METHODS: A retrospective review of Bosniak III renal lesions identified by computed tomography (CT) or magnetic resonance imaging (MRI) were collected from our patients between August 1, 2013 and December 31, 2015 who underwent surgical excision. TNM stage, histology, Fuhrman grade, and maximum lesion size data was collected...
February 23, 2018: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
O Hélénon, A Crosnier, V Verkarre, S Merran, A Méjean, J-M Correas
Ultrasound and slice imaging are currently the key modalities for diagnosing simple renal cysts. Benign simple renal cysts are defined by a set of strict criteria. Any cystic lesions that do not meet these criteria should be classified as "atypical" or "complex" and considered as suspicious. For over three decades, the Bosniak classification has been the central tool for diagnosing renal cystic masses larger than 1 cm. The Bosniak classification is based upon the results of a well-established pre- and post-contrast computed tomography (CT) protocol...
February 23, 2018: Diagnostic and Interventional Imaging
Tiana J Raphel, Davis T Weaver, Lincoln L Berland, Brian R Herts, Alec J Megibow, Amy B Knudsen, Pari V Pandharipande
Purpose To determine the effects of patient age and comorbidity level on life expectancy (LE) benefits associated with imaging follow-up of Bosniak IIF renal cysts and pancreatic side-branch (SB) intraductal papillary mucinous neoplasms (IPMNs). Materials and Methods A decision-analytic Markov model to evaluate LE benefits was developed. Hypothetical cohorts with varied age (60-80 years) and comorbidities (none, mild, moderate, or severe) were evaluated. For each finding, LE projections from two strategies were compared: imaging follow-up and no imaging follow-up...
February 5, 2018: Radiology
Jianguo Zhong, Fang Cao, Xiaojun Guan, Junfa Chen, Zhongxiang Ding, Minming Zhang
A classification system of renal cysts developed by Bosniak is based on computed tomography (CT) findings and has been applied to deal with the complex cystic renal masses. Magnetic resonance (MR) has excellent soft-tissue resolution, it has been used to further evaluate some complex renal lesions, especially those suspected of containing soft tissue components and hyperattenuating cystic lesions seen on CT. Compared with CT, MR images may find additional information, which may lead to inconsistent classification...
December 2017: Medicine (Baltimore)
Tomas Pitra, Kristyna Pivovarcikova, Radek Tupy, Reza Alaghehbandan, Tana Barakova, Ivan Travnicek, Kristyna Prochazkova, Tobias Klatte, Piotr Chlosta, Ondrej Hes, Milan Hora
INTRODUCTION: CT imaging is the standard examination for renal cystic lesions and defines the Bosniak category, which dictates further management. Given that Bosniak II/IIF/III renal cystic lesions can potentially harbor renal cell carcinoma (RCC), additional diagnostic modalities may be required in management decision making. AIM: To determine the value of additional magnetic resonance imaging in CT-defined Bosniak IIF-III renal cystic lesions. MATERIALS AND METHODS: This a multicenter retrospective study of 46 consecutive patients, diagnosed with cystic renal lesions between 2009 and 2016...
January 30, 2018: World Journal of Urology
Sheng F Oon, Robert W Foley, Deirdre Quinn, David M Quinlan, Robert G Gibney
BACKGROUND: Focal renal masses are typically evaluated by means of triphasic contrast-enhanced CT or MRI scan but use of iodinated contrast or gadolinium is unsuitable for some patients. Contrast-enhanced ultrasound (CEUS) is an imaging alternative in this scenario but has limited availability in Ireland. AIM: The aim of the study was to retrospectively evaluate experience with selective use of CEUS for non-invasive characterization of focal renal masses in a tertiary referral institution in Ireland, with a particular focus on cystic renal lesions and the influence of CEUS on final Bosniak classification and treatment outcomes...
December 7, 2017: Irish Journal of Medical Science
Eric M Hu, James H Ellis, Stuart G Silverman, Richard H Cohan, Elaine M Caoili, Matthew S Davenport
RATIONALE AND OBJECTIVE: We aimed to determine the frequency and clinical significance of homogeneous renal masses measuring 21-39 Hounsfield units on contrast-enhanced computed tomography (CT). METHODS: Subjects 40-69 years old undergoing portal-venous-phase contrast-enhanced abdominal CT from January 1, 2006 to December 31, 2010 with slice thickness ≤5 mm and no prior CT or magnetic resonance imaging were identified (n = 1387) for this institutional review board-approved retrospective cohort study...
February 2018: Academic Radiology
Peter Weibl, Milan Hora, Boris Kollarik, Kristina Kalusova, Tomas Pitra, Mesut Remzi, Wilhelm Hübner, Pascal Balzer, Tobias Klatte
OBJECTIVES: To analyse the management, pathology and outcomes of complex renal cystic masses (CRCM) and to develop a decision-making tool for daily clinical care using the Bosniak classification system for CRCM. PATIENTS AND METHODS: A comprehensive dataset of 185 patients with 188 CRCM and a minimum follow-up of 3 years were analysed for management, pathology and outcomes. RESULTS: We analysed 35 Bosniak II, 34 Bosniak IIF, 58 Bosniak III, and 61 Bosniak IV lesions...
June 2017: Arab Journal of Urology
Pedro N Mousessian, Fernando I Yamauchi, Thais C Mussi, Ronaldo H Baroni
OBJECTIVE: The primary purpose of this study is to determine the malignancy rate, histologic grade, and initial stage of surgically treated complex renal cysts classified as Bosniak category III or IV. For nonsurgical lesions, a secondary objective was to evaluate lesion progression on follow-up examinations. MATERIALS AND METHODS: We searched our database for cystic lesions classified as Bosniak III or IV category on CT or MRI from January 2008 to April 2016. Surgically resected lesions, per category, were correlated with information on pathologic reports to obtain malignancy rates...
December 2017: AJR. American Journal of Roentgenology
Thenappan Chandrasekar, Ardalan E Ahmad, Kamel Fadaak, Kartik Jhaveri, Jaimin R Bhatt, Michael A S Jewett, Antonio Finelli
PURPOSE: We evaluated intervention rates, progression and cancer specific survival outcomes in patients with complex renal cysts in a single center experience. MATERIALS AND METHODS: We used the Montage™ radiology data mining system to retrospectively identify all reported cases of complex renal cyst at our institution from 2001 to 2013. The primary study end points were overall and cancer specific survival. The secondary end points included radiographic progression and upgrading, clinical progression and final histology on surgical pathology...
September 20, 2017: Journal of Urology
Hussein D Aoun, Peter J Littrup, Mohamed Jaber, Fatima Memon, Barbara Adam, Mark Krycia, Matthew Prus, Elisabeth Heath, Edson Pontes
PURPOSE: To retrospectively assess long-term outcomes of percutaneous renal cryoablation, including factors affecting complications and local recurrence rates. MATERIALS AND METHODS: A total of 357 computed tomographic (CT) fluoroscopy-guided percutaneous cryoablation procedures were performed for 382 masses in 302 outpatients; 347 were biopsy-proven renal-cell carcinoma (RCC) or Bosniak category > III masses (n = 28). Benign pathologic conditions (n = 18) or metastatic non-RCC disease (n = 17) were included to analyze procedural complication rate, but recurrence rates, tumor staging, and nephrometry score were limited to RCCs...
October 2017: Journal of Vascular and Interventional Radiology: JVIR
Marilia Henrique Destefani, Jorge Elias, Annelise Manzano Serra Negra Trazzi, Plinio Prizon Kajiwara, Aila Ferreira de Menezes, Rodolfo Borges Dos Reis, Valdair Francisco Muglia
We correlated contrast-enhanced cross-sectional imaging and outcomes to assess the reproducibility of ultrasonographic criteria for renal minimally complex (MC) cysts. From 2003 to 2015, 143 cysts were described as complex or MC by ultrasound (US). After exclusions, 98 US studies were retrospectively evaluated and compared with computed tomography (CT)/magnetic resonance imaging (MRI). At sonography, 51 were MC cysts and 47 were complexes according to two independent observers. Inter-observer agreement for US was 0...
October 2017: Ultrasound in Medicine & Biology
Mahadevaswamy Siddaiah, Satheesh Krishna, Matthew D F McInnes, Jeffrey S Quon, Wael M Shabana, Demetri Papadatos, Nicola Schieda
OBJECTIVE: The purpose of this study was to evaluate the ability of ultrasound (US) to characterize hyperattenuating cysts detected as indeterminate hyperattenuating renal lesions on unenhanced and single phase enhanced CT. MATERIALS AND METHODS: A total of 107 consecutive homogeneously hyperattenuating renal lesions underwent gray-scale and Doppler US at our institution between 2010 and 2013. Two radiologists who were unaware of the final diagnosis retrospectively evaluated US images for visibility and diagnosis (simple cyst, intermediate complexity cyst, cystic or solid mass showing internal flow on Doppler US, or indeterminate)...
September 2017: AJR. American Journal of Roentgenology
Robert C Minnee, Hendrikus J A N Kimenai, Paul C Verhagen, Jan H von der Thüsen, Roy S Dwarkasing, Jacqueline van de Wetering, Jan N IJzermans
BACKGROUND The Bosniak system for radiological classification of renal cysts offers a tool for surgical decision-making in clinical practice. Although 95% of Bosniak 2F cysts remain benign, a consensus on the management of Bosniak 2F cysts in kidney donation has not been developed. CASE REPORT We present a donor with a Bosniak 2F cyst, who successfully donated her kidney after partial resection of the Bosniak 2F cyst. Postoperative pathology examination of the partially resected cystic wall revealed a multilocular cystic renal cell carcinoma...
June 30, 2017: American Journal of Case Reports
P Chan, S Vélasco, G Vesselle, S Boucebci, G Herpe, B Debaene, P Ingrand, J Irani, J-P Tasu
AIM: To evaluate the safety and efficiency of percutaneous microwave ablation (MWA) of renal cell carcinomas (RCC) carried out under computed tomography (CT) guidance. MATERIALS AND METHODS: A retrospective study was performed on RCC that was either histologically proven or diagnosed at imaging (Bosniak IV cyst) and treated by MWA under general anaesthesia with CT guidance. Indications for percutaneous ablation were based on the American Urological Association recommendations...
September 2017: Clinical Radiology
Yukiko Honda, Keisuke Goto, Yuko Nakamura, Hiroaki Terada, Kazuhiro Sentani, Wataru Yasui, Yohei Sekino, Tetsutaro Hayashi, Jun Teishima, Akio Matsubara, Tomoyo Fuji, Yoko Kaichi, Toru Higaki, Yasutaka Baba, Makoto Iida, Kazuo Awai
PURPOSE: Papillary renal cell carcinoma (P-RCC) typically exhibits a homogeneous, solid hypovascular mass; P-RCC with a cystic appearance is atypical. Tubulocystic RCC (TC-RCC), a newly proposed entity for renal tumors in the 2016 WHO classification, and cystic papillary RCC, may yield similar imaging findings. Therefore, we investigated the incidence of papillary RCC with cystic changes and compared its CT and pathologic features to differentiate between two entities. METHODS: We retrospectively evaluated 26 consecutive patients diagnosed with P-RCC...
July 2017: Abdominal Radiology
Indraneel Banerjee, Vinay Tomar, Sher Singh Yadav, Nachiket Vyas, Shyam Talreja
A 20-year-old woman presented to our outpatient clinic with a 5-week history of recurrent right lumbar back pain. Contrast-enhanced computed tomography scan showed a Bosniak class IV renal cyst. She was treated with radical nephrectomy. Histopathology revealed xanthogranulomatous pyelonephritis.
2017: Reviews in Urology
Pavel Grasgruber, Stevo Popović, Dominik Bokuvka, Ivan Davidović, Sylva Hřebíčková, Pavlína Ingrová, Predrag Potpara, Stipan Prce, Nikola Stračárová
The aim of this anthropometric survey, conducted between 2015 and 2016 in Bosnia and Herzegovina (BiH), was to map local geographical differences in male stature and some other anthropometric characteristics (sitting height, arm span). In addition, to investigate the main environmental factors influencing physical growth, the documented values of height would be compared with available nutritional and socioeconomic statistics. Anthropometric data were collected in 3192 boys aged approximately 18.3 years (17-20 years), from 97 schools in 37 towns...
April 2017: Royal Society Open Science
Steven Campbell, Robert G Uzzo, Mohamad E Allaf, Eric B Bass, Jeffrey A Cadeddu, Anthony Chang, Peter E Clark, Brian J Davis, Ithaar H Derweesh, Leo Giambarresi, Debra A Gervais, Susie L Hu, Brian R Lane, Bradley C Leibovich, Philip M Pierorazio
PURPOSE: This AUA Guideline focuses on evaluation/counseling and management of adult patients with clinically localized renal masses suspicious for cancer, including solid-enhancing tumors and Bosniak 3/4 complex-cystic lesions. MATERIALS AND METHODS: Systematic review utilized research from the Agency for Healthcare Research and Quality and additional supplementation by the authors and consultant methodologists. Evidence-based statements were based on body of evidence strength Grade A/B/C (Strong/Moderate/Conditional Recommendations, respectively) with additional statements presented as Clinical Principles or Expert Opinions...
September 2017: Journal of Urology
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