Investigating the Differentiation of Exophytic Renal Masses with Determination of the Angular Interface to Renal Parenchyma in US and CT

Aims: Using the angular interface sign in ultrasonography (US) and computerised tomography ( CT) to assess if benign exophytic renal masses can be differentiated from malignant lesions. Background: For the interpretation of charecteristics of the cystic renal masses, the Bosnian classification of renal cysts has been widely used. Although the known sensitivity , specificity and time consumption values contrast with improved modalities for further evaluation of the Bosnian 3 or higher group, a biopsy is also needed. Materials and methods: A total of 71 cases of exophytic renal mass (2 cm or more) were investigated in the US (n = 23), CT (n = 21) and US + CT (n = 16) on the basis of angular interface between January 2008 and June 2010 and were included in this report. Two radiologists studied the renal interface relationships and categorised them as having an angular or broad interface. Results: Renal mass diagnosis with a specific indication is a reference for further assessment and treatment of these lesions. In this way, unnecessary, time-saving and cost-effective surgical procedures can be avoided. Exophytic renal masses with high specificity (91 percent) and precision (87 percent) can be distinguished as malignant or benign using only the angular interface sign in the US or CT as well. No statistically significant difference between the two readers’ findings was found. For the device symbol, there was nearly perfect interobserver agreement. For cystic lesions, in all but two Bosnian Category 1 cases, the angular interface sign was calculated. In the malignant community, in only two cases of renal cell carcinoma, the angular interface sign was determined; there was a large interface sign in other primary or metastatic malignant lesions. Conclusion: with 87 percent precision, exophytic renal masses can be distinguished as malignant or benign with only the angular interface sign in US or CT and often in opposition to dynamic-contrast examinations. This approach includes a lack of additional exposure to radiation or contrast media, time savings, and cost effectiveness.

Author(s) Details

Duzgun Yildirim
Department of Radiology, Acıbadem University, Istanbul, Turkey.

Halil Bozkurt
Department of Urology, Izmır Buca Training and Research Hospital, Izmır, Turkey.

Abdullah Cirakoglu
Department of Urology, Ordu Training and Research Hospital, Ordu, Turkey.

Mutlu Sahin
Department of Surgery, University of Health Sciences Keçiören Training and Research Hospital, Ankara, Turkey.

Bengi Gurses
Department of Radiology, Koç University Hospital, Istanbul, Turkey.

Baki Ekci
Department of Surgery, Yeditepe University Hospital, Istanbul, Turkey.

Özlem Güngör
Department of Radiology, Sancaktepe Professor İlhan Varank Training and Research Hospital, Istanbul, Turkey.

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