Contrast-enhanced ultrasound (CEUS) imaging for active surveillance of small renal masses.
Aged
Carcinoma, Renal Cell
/ diagnostic imaging
Comparative Effectiveness Research
Contrast Media
/ pharmacology
Dimensional Measurement Accuracy
Female
Humans
Image Enhancement
/ methods
Italy
/ epidemiology
Kidney Neoplasms
/ diagnostic imaging
Male
Middle Aged
Outcome and Process Assessment, Health Care
Tomography, X-Ray Computed
/ methods
Tumor Burden
Ultrasonography
/ methods
Watchful Waiting
/ methods
Active surveillance
Contrast-enhanced ultrasound (CEUS)
Cyst
Renal neoplasm
Small renal mass
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
11
11
2020
accepted:
05
01
2021
pubmed:
27
1
2021
medline:
11
1
2022
entrez:
26
1
2021
Statut:
ppublish
Résumé
To assess the safety and efficacy of contrast-enhanced ultrasound (CEUS) imaging for monitoring small (< 4 cm) renal masses (SRM) in patients undergoing active surveillance (AS). We retrospectively selected all consecutive patients with SRMs who underwent AS for at least 6 months at our Institution between January 2014 and December 2018. CEUS imaging was performed by two experienced genitourinary radiologists at established time points. The accuracy of CEUS for monitoring SRM size was compared with that of CT scan. For solid SRMs, four enhancement patterns (EP) were recorded. Radiological progression was defined as SRM growth rate ≥ 5 mm/year. Overall, 158/1049 (15.1%) patients with SRMs underwent AS. At a median follow-up of 25 months (IQR 13-39), no patient died due to renal cell carcinoma (RCC). No patients experienced CEUS-related adverse events. There was a large variability in the pattern of growth of SRMs (overall median growth rate: 0.40 mm/year), with 9.5% of SRMs showing radiological progression. The median SRM size was comparable between CEUS and CT scan examinations at all time points. The vast majority (92.7%) of SRMs did not show a change in their EP over time; and there was no association between the SRM's EP and radiological progression or SRM size. Overall, 43 (27.2%) patients underwent delayed intervention (DI); median SRM size, and median growth rate were significantly higher in these patients as compared to those continuing AS. In experienced hands, CEUS is a safe and effective strategy for active monitoring of SRMs in well-selected patients undergoing AS.
Identifiants
pubmed: 33495864
doi: 10.1007/s00345-021-03589-6
pii: 10.1007/s00345-021-03589-6
doi:
Substances chimiques
Contrast Media
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2853-2860Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.
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