{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T16:31:45Z","timestamp":1793464305570,"version":"4.5.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Urol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Renal cysts comprise benign and malignant entities. Risk assessment profits from CT\/MRI imaging using the Bosniak classification. While Bosniak-IIF, -III, and -IV cover complex cyst variants, Bosniak-IIF and -III stand out due to notorious overestimation. Contrast-enhanced ultrasound (CEUS) is promising to overcome this deficit but warrants standardization. This study addresses the benefits of a combined CEUS and CT\/MRI evaluation of renal cysts. The study provides a realistic account of kidney tumor boards' intricacies in trying to validate renal cysts.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>247 patients were examined over 8\u00a0years. CEUS lesions were graded according to CEUS-Bosniak (IIF, III, IV). 55 lesions were resected, CEUS-Bosniak- and CT\/MRI-Bosniak-classification were correlated with histopathological diagnosis. Interobserver agreement between the classifications was evaluated statistically. 105 lesions were followed by ultrasound, and change in CEUS-Bosniak-types and lesion size were documented.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>146 patients (156 lesions) were included. CEUS classified 67 lesions as CEUS-Bosniak-IIF, 44 as CEUS-Bosniak-III, and 45 as CEUS-Bosniak-IV. Histopathology of 55 resected lesions revealed benign cysts in all CEUS-Bosniak-IIF lesions (2\/2), 40% of CEUS-Bosniak-III and 8% of CEUS-Bosniak-IV, whereas malignancy was uncovered in 60% of CEUS-Bosniak-III and 92% of CEUS-Bosniak-IV. Overall, CEUS-Bosniak-types matched CT\/MRI-Bosniak types in 58% (fair agreement, \u03ba\u2009=\u20090.28). CEUS-Bosniak resulted in higher stages than CT\/MRI-Bosniak (40%). Ultrasound follow-up of 105 lesions detected no relevant differences between CEUS-Bosniak-types concerning cysts size. 99% of lesions showed the same CEUS-Bosniak-type.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The CEUS-Bosniak classification is an essential tool in clinical practice to differentiate and monitor renal cystic lesions and empowers diagnostic work-up and patient care.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00345-022-04094-0","type":"journal-article","created":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T14:02:32Z","timestamp":1661004152000},"page":"679-685","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Ultrasound-based \u201cCEUS-Bosniak\u201dclassification for cystic renal lesions: an 8-year clinical experience"],"prefix":"10.1007","volume":"41","author":[{"given":"Elena","family":"Herms","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Weirich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Maurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Wagenpfeil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Preuss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Sauter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Heck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"G\u00e4rtner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Hauner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Autenrieth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert P.","family":"K\u00fcbler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"Holzapfel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Schwarz-Boeger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Heemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Slotta-Huspenina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3164-7192","authenticated-orcid":false,"given":"Konrad Friedrich","family":"Stock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,20]]},"reference":[{"issue":"9","key":"4094_CR1","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1111\/j.1464-410X.2004.04844.x","volume":"93","author":"N Terada","year":"2004","unstructured":"Terada N, Arai Y, Kinukawa N, Yoshimura K, Terai A (2004) Risk factors for renal cysts. BJU Int 93(9):1300\u20131302","journal-title":"BJU Int"},{"issue":"4","key":"4094_CR2","doi-asserted-by":"publisher","first-page":"729","DOI":"10.3349\/ymj.2012.53.4.729","volume":"53","author":"HH Han","year":"2012","unstructured":"Han HH, Choi KH, Oh YT, Yang SC, Han WK (2012) Differential diagnosis of complex renal cysts based on lesion size along with the Bosniak renal cyst classification. Yonsei Med J 53(4):729\u2013733","journal-title":"Yonsei Med J"},{"issue":"1","key":"4094_CR3","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1148\/radiol.2431051924","volume":"243","author":"G Ascenti","year":"2007","unstructured":"Ascenti G, Mazziotti S, Zimbaro G, Settineri N, Magno C, Melloni D et al (2007) Complex cystic renal masses: characterization with contrast-enhanced US. Radiology 243(1):158\u2013165","journal-title":"Radiology"},{"issue":"1","key":"4094_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1148\/radiology.158.1.3510019","volume":"158","author":"MA Bosniak","year":"1986","unstructured":"Bosniak MA (1986) The current radiological approach to renal cysts. Radiology 158(1):1\u201310","journal-title":"Radiology"},{"issue":"8","key":"4094_CR5","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1016\/S0009-9260(03)00165-X","volume":"58","author":"ZI Carrim","year":"2003","unstructured":"Carrim ZI, Murchison JT (2003) The prevalence of simple renal and hepatic cysts detected by spiral computed tomography. Clin Radiol 58(8):626\u2013629","journal-title":"Clin Radiol"},{"issue":"3","key":"4094_CR6","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1016\/j.urology.2013.05.016","volume":"82","author":"AH Goenka","year":"2013","unstructured":"Goenka AH, Remer EM, Smith AD, Obuchowski NA, Klink J, Campbell SC (2013) Development of a clinical prediction model for assessment of malignancy risk in Bosniak III renal lesions. Urology 82(3):630\u2013635","journal-title":"Urology"},{"issue":"3","key":"4094_CR7","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1148\/radiol.11111595","volume":"262","author":"MA Bosniak","year":"2012","unstructured":"Bosniak MA (2012) The Bosniak renal cyst classification: 25 years later. Radiology 262(3):781\u2013785","journal-title":"Radiology"},{"issue":"2","key":"4094_CR8","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1148\/radiol.2019182646","volume":"292","author":"SG Silverman","year":"2019","unstructured":"Silverman SG, Pedrosa I, Ellis JH, Hindman NM, Schieda N, Smith AD et al (2019) Bosniak classification of cystic renal masses, version 2019: an update proposal and needs assessment. Radiology 292(2):475\u2013488","journal-title":"Radiology"},{"issue":"1","key":"4094_CR9","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1148\/radiol.11110888","volume":"262","author":"AD Smith","year":"2012","unstructured":"Smith AD, Remer EM, Cox KL, Lieber ML, Allen BC, Shah SN et al (2012) Bosniak category IIF and III cystic renal lesions: outcomes and associations. Radiology 262(1):152\u2013160","journal-title":"Radiology"},{"issue":"9","key":"4094_CR10","doi-asserted-by":"publisher","first-page":"2549","DOI":"10.3390\/cancers12092549","volume":"12","author":"J Lucocq","year":"2020","unstructured":"Lucocq J, Pillai S, Oparka R, Nabi G (2020) Complex renal cysts (Bosniak \u2265 IIF): outcomes in a population-based Cohort Study. Cancers (Basel). 12(9):2549","journal-title":"Cancers (Basel)."},{"issue":"1","key":"4094_CR11","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1148\/radiol.2261011704","volume":"226","author":"GM Israel","year":"2003","unstructured":"Israel GM, Bosniak MA (2003) Calcification in cystic renal masses: is it important in diagnosis? Radiology 226(1):47\u201352","journal-title":"Radiology"},{"issue":"2","key":"4094_CR12","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1007\/s00330-020-07186-w","volume":"31","author":"J Lucocq","year":"2021","unstructured":"Lucocq J, Pillai S, Oparka R, Nabi G (2021) Complex renal cysts (Bosniak \u2265IIF): interobserver agreement, progression and malignancy rates. Eur Radiol 31(2):901\u2013908","journal-title":"Eur Radiol"},{"issue":"3","key":"4094_CR13","doi-asserted-by":"publisher","first-page":"813","DOI":"10.2214\/ajr.169.3.9275902","volume":"169","author":"CL Siegel","year":"1997","unstructured":"Siegel CL, McFarland EG, Brink JA, Fisher AJ, Humphrey P, Heiken JP (1997) CT of cystic renal masses: analysis of diagnostic performance and interobserver variation. AJR Am J Roentgenol 169(3):813\u2013818","journal-title":"AJR Am J Roentgenol"},{"key":"4094_CR14","doi-asserted-by":"publisher","DOI":"10.1055\/a-1526-1981","author":"V Cantisani","year":"2020","unstructured":"Cantisani V, Bertolotto M, Clevert DA, Correas JM, Drudi FM, Fischer T, EFSUMB, et al (2020) Proposal for a contrast-enhanced ultrasound-adapted bosniak cyst categorization - position statement. Ultraschall Med. https:\/\/doi.org\/10.1055\/a-1526-1981","journal-title":"Ultraschall Med"},{"key":"4094_CR15","doi-asserted-by":"crossref","unstructured":"Moch H, Humphrey PA, Ulbright TM, Reuter VE (2016) WHO classification of tumours of the urinary system and male genital organs. 4 ed: Int Agency Res Cancer","DOI":"10.1016\/j.eururo.2016.02.029"},{"issue":"1","key":"4094_CR16","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.juro.2016.09.160","volume":"198","author":"IG Schoots","year":"2017","unstructured":"Schoots IG, Zaccai K, Hunink MG, Verhagen P (2017) Bosniak classification for complex renal cysts reevaluated: a systematic review. J Urol 198(1):12\u201321","journal-title":"J Urol"},{"issue":"3","key":"4094_CR17","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1016\/j.juro.2017.09.078","volume":"199","author":"T Chandrasekar","year":"2018","unstructured":"Chandrasekar T, Ahmad AE, Fadaak K, Jhaveri K, Bhatt JR, Jewett MAS et al (2018) Natural history of complex renal cysts: clinical evidence supporting active surveillance. J Urol 199(3):633\u2013640","journal-title":"J Urol"},{"issue":"10","key":"4094_CR18","doi-asserted-by":"publisher","first-page":"1643","DOI":"10.1007\/s00345-018-2307-6","volume":"36","author":"FX Nouhaud","year":"2018","unstructured":"Nouhaud FX, Bernhard JC, Bigot P, Khene ZE, Audenet F, Lang H et al (2018) Contemporary assessment of the correlation between Bosniak classification and histological characteristics of surgically removed atypical renal cysts (UroCCR-12 study). World J Urol 36(10):1643\u20131649","journal-title":"World J Urol"},{"issue":"12","key":"4094_CR19","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.7863\/jum.2005.24.12.1635","volume":"24","author":"H Tamai","year":"2005","unstructured":"Tamai H, Takiguchi Y, Oka M, Shingaki N, Enomoto S, Shiraki T et al (2005) Contrast-enhanced ultrasonography in the diagnosis of solid renal tumors. J Ultrasound Med 24(12):1635\u20131640","journal-title":"J Ultrasound Med"},{"key":"4094_CR20","doi-asserted-by":"crossref","unstructured":"Mueller-Peltzer K, Negrao de Figueiredo G, Graf T, R\u00fcbenthaler J, Clevert DA. Papillary renal cell carcinoma in contrast-enhanced ultrasound (CEUS) A diagnostic performance study. Clin Hemorheol Microcirc. 2019;71(2):159\u201364.","DOI":"10.3233\/CH-189406"},{"key":"4094_CR21","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-07964-0","author":"KY Elbanna","year":"2021","unstructured":"Elbanna KY, Jang HJ, Kim TK, Khalili K, Guimar\u00e3es LS, Atri M (2021) The added value of contrast-enhanced ultrasound in evaluation of indeterminate small solid renal masses and risk stratification of cystic renal lesions. Eur Radiol. https:\/\/doi.org\/10.1007\/s00330-021-07964-0","journal-title":"Eur Radiol"},{"issue":"2","key":"4094_CR22","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.ejrad.2006.10.004","volume":"61","author":"BK Park","year":"2007","unstructured":"Park BK, Kim B, Kim SH, Ko K, Lee HM, Choi HY (2007) Assessment of cystic renal masses based on Bosniak classification: comparison of CT and contrast-enhanced US. Eur J Radiol 61(2):310\u2013314","journal-title":"Eur J Radiol"},{"issue":"1","key":"4094_CR23","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1007\/s00092-020-4476-z","volume":"25","author":"KF Stock","year":"2021","unstructured":"Stock KF (2021) Kontrastmittelsonografie bei schwierigen zystischen Nierenl\u00e4sionen. Uro-News 25(1):32\u201335","journal-title":"Uro-News"},{"key":"4094_CR24","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1016\/j.urology.2021.04.032","volume":"154","author":"DW Tshering Vogel","year":"2021","unstructured":"Tshering Vogel DW, Kiss B, Heverhagen JT, Benackova K, Burkhard F, M\u00fcller M et al (2021) Prospective comparison of contrast-enhanced ultrasound and magnetic resonance imaging to computer tomography for the evaluation of complex cystic renal lesions. Urology 154:320\u2013325","journal-title":"Urology"},{"issue":"1","key":"4094_CR25","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1046\/j.1464-410x.1998.00689.x","volume":"82","author":"O Bielsa","year":"1998","unstructured":"Bielsa O, Lloreta J, Gelabert-Mas A (1998) Cystic renal cell carcinoma: pathological features, survival and implications for treatment. Br J Urol 82(1):16\u201320","journal-title":"Br J Urol"},{"issue":"46","key":"4094_CR26","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000023110","volume":"99","author":"K Shan","year":"2020","unstructured":"Shan K, Fu A, Liu N, Cai Q, Fu Q, Liu L et al (2020) Contrast-enhanced Ultrasound (CEUS) vs contrast-enhanced computed tomography for multilocular cystic renal neoplasm of low malignant potential: A retrospective analysis for diagnostic performance study. Medicine (Baltimore) 99(46):e23110","journal-title":"Medicine (Baltimore)"}],"container-title":["World Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-022-04094-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00345-022-04094-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-022-04094-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T10:03:08Z","timestamp":1680948188000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00345-022-04094-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,20]]},"references-count":26,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["4094"],"URL":"https:\/\/doi.org\/10.1007\/s00345-022-04094-0","relation":{},"ISSN":["1433-8726"],"issn-type":[{"value":"1433-8726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,20]]},"assertion":[{"value":"30 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 August 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This retrospective study was approved by the ethics committee of the Technical University of Munich and conducted in accordance with its guidelines.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All authors have agreed to publish the current document.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}