The following is the summary of “Cost-effectiveness of Contrast-enhanced Ultrasound for Diagnosis and Active Surveillance of Complex Cystic Renal Lesions” published in the January 2023 issue of Urology by Oh, et al.

The purpose of this study was to assess whether or not contrast-enhanced ultrasound is more cost-effective for the active surveillance of complicated kidney masses in comparison to the more conventional imaging modalities of computed tomography (CT) and magnetic resonance imaging (MRI). In TreeAge Pro, a decision-analytic Markov state microsimulation model was created. In addition, researchers created simulated independent cohorts of one hundred thousand individuals aged 60 years old with either a Bosniak IIF or Bosniak III complicated renal tumor. 

These individuals were monitored for a period of 10 years or until they passed away. The model compared 3 imaging modalities for the purpose of active surveillance of a complex renal mass: contrast-enhanced ultrasound imaging, contrast-enhanced magnetic resonance imaging, and contrast-enhanced computed tomography imaging showed that contrast-enhanced ultrasound was the most cost-effective strategy for patients over the age of 60 who had Bosniak IIF or III renal masses. This was the case even after considering varying rates of active surveillance, ranging from 10% to 100%.

Contrast-enhanced ultrasonography can be a viable and cost-effective approach in the active surveillance of Bosniak class IIF and III renal cysts. Contrast-enhanced ultrasonography was found to be reliable and continued to be the most successful technique even after the rates of active surveillance usage were changed. In the treatment of patients with Bosniak III renal cysts, contrast-enhanced ultrasound can be a safer alternative than noncontrast enhanced CT or MRI for patients who have kidney functions that are impaired. This is the case in the management of these patients.

Source: auajournals.org/doi/10.1097/UPJ.0000000000000354