Ultrasound Not Inferior for Sizing Renal Masses

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Ultrasound imaging works as well as computed tomography (CT) and magnetic resonance imaging (MRI) for evaluating renal mass size, a new study suggests.

The finding “might be beneficial for long-term active surveillance protocols to contain healthcare costs and reduce radiation exposure,” researchers concluded.

Phillip Mucksavage, MD, of the University of California in Irvine, and colleagues studied 116 patients who underwent ultrasound imaging prior to definitive therapy for a renal mass. These patients also underwent CT (66 patients) or MRI (80 patients). Thirty-three patients underwent all three imaging modalities. The average pathologic tumor size for the entire cohort was 4.45 cm.

The renal mass size differences between CT and MRI compared with ultrasound were nonsignificant (less than 3.5%), Dr. Mucksavage's team reported in Urology (2012;79:28-31). For patients who underwent ultrasound and CT, the average tumor size was 4.73 cm and 4.57 cm, respectively. For those who underwent ultrasound and MRI, the average tumor size was 4.65 cm and 4.49 cm, respectively. For patients who underwent ultrasound, CT, and MRI, the average tumor size was 4.47 cm, 4.27 cm, and 4.29 cm, respectively.

In an accompanying editorial, Maxwell V. Meng, MD, of the University of California, San Francisco, School of Medicine, observed: “Although the urologist is traditionally most comfortable interpreting cross-sectional images, particular CT, we must question the established paradigms and evolve to incorporate comparable modalities with less morbidity for the patient and reduced cost for the healthcare system.”

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