Malignancy rates and diagnostic performance of the Bosniak classification for the diagnosis of cystic renal lesions in computed tomography – a systematic review and meta-analysisReportar como inadecuado




Malignancy rates and diagnostic performance of the Bosniak classification for the diagnosis of cystic renal lesions in computed tomography – a systematic review and meta-analysis - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

European Radiology

, Volume 27, Issue 6, pp 2239–2247

First Online: 19 October 2016Received: 17 May 2016Revised: 28 September 2016Accepted: 03 October 2016DOI: 10.1007-s00330-016-4631-9

Cite this article as: Sevcenco, S., Spick, C., Helbich, T.H. et al. Eur Radiol 2017 27: 2239. doi:10.1007-s00330-016-4631-9

Abstract

ObjectiveTo systematically review the literature on the Bosniak classification system in CT to determine its diagnostic performance to diagnose malignant cystic lesions and the prevalence of malignancy in Bosniak categories.

MethodsA predefined database search was performed from 1 January 1986 to 18 January 2016. Two independent reviewers extracted data on malignancy rates in Bosniak categories and several covariates using predefined criteria. Study quality was assessed using QUADAS-2. Meta-analysis included data pooling, subgroup analyses, meta-regression and investigation of publication bias.

ResultsA total of 35 studies, which included 2,578 lesions, were investigated. Data on observer experience, inter-observer variation and technical CT standards were insufficiently reported. The pooled rate of malignancy increased from Bosniak I 3.2 %, 95 % CI 0–6.8, I = 5 % to Bosniak II 6 %, 95 % CI 2.7–9.3, I = 32 %, IIF 6.7 %, 95 % CI 5–8.4, I = 0 %, III 55.1 %, 95 % CI 45.7–64.5, I = 89 % and IV 91 %, 95 % CI 87.7–94.2, I = 36. Several study design-related influences on malignancy rates and subsequent diagnostic performance indices were identified.

ConclusionThe Bosniak classification is an accurate tool with which to stratify the risk of malignancy in renal cystic lesions.

Key points• The Bosniak classification can accurately rule out malignancy.

• Specificity remains moderate at 74 % 95 % CI 64–82.

• Follow-up examinations should be considered in Bosniak IIF and Bosniak II cysts.

• Data on the influence of reader experience and inter-reader variability are insufficient.

• Technical CT standards and publication year did not influence diagnostic performance.

KeywordsBosniak classification Renal cysts Kidney cancer Meta-analysis Systematic review Electronic supplementary materialThe online version of this article doi:10.1007-s00330-016-4631-9 contains supplementary material, which is available to authorized users.





Autor: Sabina Sevcenco - Claudio Spick - Thomas H. Helbich - Gertraud Heinz - Shahrokh F. Shariat - Hans C. Klingler - Michael 

Fuente: https://link.springer.com/







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