How accurate is ultrasonography in the diagnosis of renal cell carcinoma (RCC)?

Updated: Dec 13, 2018
  • Author: Deborah A Baumgarten, MD, MPH; Chief Editor: Eugene C Lin, MD  more...
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Confidence in tumor detection is increased as lesions increase in size. Larger lesions are usually more heterogeneous and more often hypoechoic. In a reported series, a detection rate of 85% was seen in lesions larger than 3 cm. [51] A detection rate of less than 60% was seen in lesions smaller than 2 cm.

Confidence also increases if lesions are solid, lobulated, or well differentiated from the normal parenchyma; if they have poor through-transmission; and if they show flow with CEUS.

False-positive results are rare because US is seldom the sole imaging modality used prior to intervention.

A prominent column of Bertin or fetal lobulation may mimic a solid renal mass and can be resolved with a dedicated CT or MRI examination.

False-negative findings can occur if care is not taken to fully examine all aspects of the kidney, because US is highly operator-dependent. False-negative results are also possible if the RCC is small, is isoechoic to the parenchyma, and/or is not contour deforming.

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