Bosniak classification version 2019: a prospective comparison of CT and MRI.
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Almalki Yassir Edrees, Basha Mohammad Abd Alkhalik, Refaat Rania, Alduraibi Sharifa Khalid, Abdalla Ahmed A El-Hamid M, Yousef Hala Y, Zaitoun Mohamed M A, Elsayed Saeed Bakry, Mahmoud Nader E M, Alayouty Nader Ali, Ali Susan Adil, Alnaggar Ahmad Abdullah, Saber Sameh, El-Maghraby Ahmed Mohamed, Elsheikh Amgad M, Radwan Mohamed Hesham Saleh Saleh, Abdelmegid Ahmed Gamil Ibrahim, Aly Sameh Abdelaziz, Shanab Waleed S Abo, Obaya Ahmed Ali, Abdelhai Shaimaa Farouk, Elshorbagy Shereen, Haggag Yasser M, Mokhtar Hwaida M, Sabry Nesreen M, Altohamy Jehan Ibrahim, Abouelkheir Rasha Taha, Omran Tawfik, Shalan Ahmed, Algazzar Youssef H, Metwally Maha Ibrahim
Аннотация
MATERIALS AND METHODS: A prospective multi-institutional study enrolled 63 patients with 67 complicated cystic renal masses (CRMs) discovered during ultrasound examination. All patients underwent CT and MRI scans and histopathology. Three radiologists independently assessed CRMs using BCv2019 and assigned Bosniak class to each CRM using CT and MRI. The final analysis included 60 histopathologically confirmed CRMs (41 were malignant and 19 were benign).
RESULTS: Discordance between CT and MRI findings was noticed in 50% (30/60) CRMs when data were analyzed in terms of the Bosniak classes. Of these, 16 (53.3%) were malignant. Based on consensus reviewing, there was no difference in the sensitivity, specificity, and accuracy of the BCv2019 with MRI and BCv2019 with CT (87.8%; 95% CI = 73.8-95.9% versus 75.6%; 95% CI = 59.7-87.6%; p = 0.09, 84.2%; 95% CI = 60.4-96.6% versus 78.9%; 95% CI = 54.4-93.9%; p = 0.5, and 86.7%; 95% CI = 64.0-86.6% versus 76.7%; 95% CI = 75.4-94.1%; p = 0.1, respectively). The number and thickness of septa and the presence of enhanced nodules accounted for the majority of variations in Bosniak classes between CT and MRI. The inter-reader agreement (IRA) was substantial for determining the Bosniak class in CT and MRI (k = 0.66; 95% CI = 0.54-0.76, k = 0.62; 95% CI = 0.50-0.73, respectively). The inter-modality agreement of the BCv219 between CT and MRI was moderate (κ = 0.58).
CONCLUSION: In terms of BCv2019, CT and MRI are comparable in the classification of CRMs with no significant difference in diagnostic accuracy and reliability.
KEY POINTS: • There is no significant difference in the sensitivity, specificity, and accuracy of the BCv2019 with MRI and BCv2019 with CT. • The number of septa and their thickness and the presence of enhanced nodules accounted for the majority of variations in Bosniak classes between CT and MRI. • The inter-reader agreement was substantial for determining the Bosniak class in CT and MRI and the inter-modality agreement of the BCv219 between CT and MRI was moderate.