Ultrasound useful in further IDing hyperattenuating renal lesions

Though most hyperattenuating renal lesions are detected using CT, a new study published in the American Journal of Roentgenology suggests that ultrasound also proves useful in identifying those specific lesions.

“Ultrasound can be used for characterizing renal masses, is readily available and is relatively inexpensive,” wrote Mahadevaswamy Siddaiah, MD, with the Ottawa Hospital in Canada, and colleagues. “Ultrasound can be performed to characterize hyperattenuating lesions detected at CT, but evidence supporting its use is limited.”

The researchers conducted the study to determine the efficacy of ultrasounds for further characterization of hyperattenuating renal lesions detected on CT. Furthermore, they sought to determine what factors may influence ultrasound visibility and assess what proportion of hyperattenuating cysts will appear simple on ultrasound, enabling benign diagnosis.

In this retrospective study, the final study population included 107 patients who underwent ultrasound to further characterize a renal lesion detected on CT.

Two radiologists who were unaware of the final diagnosis evaluated ultrasound images for visibility and diagnosis. A third radiologist assessed lesion size, location and distance to skin on CT and ultrasound.

Final results showed that ultrasound can visualize a substantial majority of hyperattenuating renal lesions, including lesions measuring 15 millimeters or greater. Furthermore, ultrasound was accurate in diagnosing hyperattenuating simple cysts with very low false-positive rate and a false negative rate.

“Our study results, combined with what has already been reported, suggest that ultrasound should be the next-step imaging test for characterization of indeterminate homogeneously hyperattenuating renal lesions encountered at CT,” Siddaiah et al. wrote.