{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T23:45:49Z","timestamp":1776901549501,"version":"3.51.2"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1127","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJR"],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:sec><jats:title>Objective:<\/jats:title><jats:p> To investigate the impact of contrast-enhanced ultrasound (CEUS) in reclassifying incidental renal findings categorized as indeterminate lesions (IL) or Bosniak \u2265 2F complex renal cysts (CRC) on CT or MRI. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> We retrospectively included 44 subjects who underwent CEUS between 2016 and 2019 to assess 48 IL (n = 12) and CRC (n = 36) incidentally found on CT or MRI. CEUS was performed by one radiologist with 10\u2009year of experience with a sulfur hexafluoride-filled microbubble contrast agent. The same radiologist, blinded to clinical information and previous CT\/MRIs, retrospectively reviewed CEUS images\/videos, categorizing renal findings with Bosniak-derived imaging categories ranging from 0 (indeterminate) to 5 (solid lesion). CEUS-related reclassification rate was calculated (proportion of IL reclassified with an imaging category &gt;0, or CRC reclassified below or above imaging category &gt;2F). Using histological examination or a \u2265 24\u2009months follow-up as the standard of reference, we also estimated per-lesion sensitivity\/specificity for malignancy. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> CEUS reclassified 24\/48 findings (50.0%; 95% C.I. 35.2\u201364.7), including 12\/12 IL (100%; 95%\u2009CI 73.5\u2013100) and 12\/36 CRC (33.3%; 95% C.I. 18.5\u201350.9), mostly above category &gt;2F (66.7%). CEUS and CT\/MRI showed 96.0% (95%CI 79.7\u201399.9) vs 44.0% (95%CI 24.4\u201365.1) sensitivity, and 82.6% (95%CI 61.2\u201395.1) vs 60.9% (95%CI 38.5\u201380.3%) specificity. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> CEUS provided substantial and accurate reclassification of CT\/MRI incidental findings. <\/jats:p><\/jats:sec><jats:sec><jats:title>Advances in knowledge:<\/jats:title><jats:p> Previous studies included Bosniak 2 incidental findings, thus possibly underestimating CEUS-induced reclassification rates. Using a more meaningful cut-off (Bosniak \u22652F), problem-solving CEUS was effective as well, with higher reclassification rates for CRC than in literature. <\/jats:p><\/jats:sec>","DOI":"10.1259\/bjr.20210707","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T18:20:07Z","timestamp":1629915607000},"source":"Crossref","is-referenced-by-count":8,"title":["Role of contrast-enhanced ultrasound in assessing indeterminate renal lesions and Bosniak \u22652F complex renal cysts found incidentally on CT or MRI"],"prefix":"10.1093","volume":"94","author":[{"given":"Giuseppe","family":"Como","sequence":"first","affiliation":[{"name":"Institute of Radiology, Department of Medicine, University of udine, University Hospital S. Maria della Misericordia, Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Valotto","sequence":"additional","affiliation":[{"name":"Urology Unit, University Hospital S. Maria della Misericordia, Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Tulipano Di Franco","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Department of Medicine, University of udine, University Hospital S. Maria della Misericordia, Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Giannarini","sequence":"additional","affiliation":[{"name":"Urology Unit, University Hospital S. Maria della Misericordia, Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Cereser","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Department of Medicine, University of udine, University Hospital S. 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