Evidence map›Paper›PMID 33495864›Full record

ArticleWorld journal of urology2021

Contrast-enhanced ultrasound (CEUS) imaging for active surveillance of small renal masses.

Elena Bertelli, Alberto Palombella, Francesco Sessa, Irene Baldi, Noemi Morelli, Silvia Verna, Isabella Greco, Simone Morselli, Alessandro Pili, Arcangelo Sebastianelli and 9 more

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In one paragraph

Article in World journal of urology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

  1. Pooled it
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  3. Article
  4. Review
  5. Article
  6. Article
  7. Renal cancer: overdiagnosis and overtreatment.World journal of urology · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 2 institutions in 1 country.

Elena BertelliDepartment of Radiology, Careggi University Hospital, Florence, Italy. elena.bertelli3@gmail.com.ORCID http://orcid.org/0000-0001-5218-7733
Alberto PalombellaDepartment of Radiology, Careggi University Hospital, Florence, Italy.
Francesco SessaDepartment of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.
Irene BaldiDepartment of Radiology, Careggi University Hospital, Florence, Italy.
Noemi MorelliDepartment of Radiology, Careggi University Hospital, Florence, Italy.
Silvia VernaDepartment of Radiology, Careggi University Hospital, Florence, Italy.
Isabella GrecoDepartment of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.
Simone MorselliDepartment of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.
Alessandro PiliDepartment of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.
Arcangelo SebastianelliDepartment of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.
Alessandro BerniDepartment of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.
Rossella NicolettiDepartment of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.
Andrea MinerviniDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Marco CariniDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Mauro GacciDepartment of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.
Vittorio Miele *Department of Radiology, Careggi University Hospital, Florence, Italy.
Simone Agostini *Department of Radiology, Careggi University Hospital, Florence, Italy.
Sergio Serni *Department of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.
Riccardo Campi *Department of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.
University of Florence · ITAzienda Ospedaliero-Universitaria Careggi · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the safety and efficacy of contrast-enhanced ultrasound (CEUS) imaging for monitoring small (< 4 cm) renal masses (SRM) in patients undergoing active surveillance (AS).

methodsWe retrospectively selected all consecutive patients with SRMs who underwent AS for at least 6 months at our Institution between January 2014 and December 2018. CEUS imaging was performed by two experienced genitourinary radiologists at established time points. The accuracy of CEUS for monitoring SRM size was compared with that of CT scan. For solid SRMs, four enhancement patterns (EP) were recorded. Radiological progression was defined as SRM growth rate ≥ 5 mm/year.

resultsOverall, 158/1049 (15.1%) patients with SRMs underwent AS. At a median follow-up of 25 months (IQR 13-39), no patient died due to renal cell carcinoma (RCC). No patients experienced CEUS-related adverse events. There was a large variability in the pattern of growth of SRMs (overall median growth rate: 0.40 mm/year), with 9.5% of SRMs showing radiological progression. The median SRM size was comparable between CEUS and CT scan examinations at all time points. The vast majority (92.7%) of SRMs did not show a change in their EP over time; and there was no association between the SRM's EP and radiological progression or SRM size. Overall, 43 (27.2%) patients underwent delayed intervention (DI); median SRM size, and median growth rate were significantly higher in these patients as compared to those continuing AS.

conclusionIn experienced hands, CEUS is a safe and effective strategy for active monitoring of SRMs in well-selected patients undergoing AS.

Indexed as

Carcinoma, Renal CellKidney NeoplasmsWatchful WaitingAgedComparative Effectiveness ResearchContrast MediaDimensional Measurement AccuracyFemaleHumansImage EnhancementItalyMaleMiddle AgedOutcome and Process Assessment, Health CareTomography, X-Ray ComputedTumor BurdenContrast MediaActive surveillanceContrast-enhanced ultrasound (CEUS)CystRenal neoplasmSmall renal mass

Identifiers

PMID33495864
OpenAlexW3124182762

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.