Diagnostic accuracy of contrast-enhanced ultrasound for detecting renal cancer: a systematic review and meta-analysis

Authors

  • Renfan Xu Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
  • Yunqi He Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
  • Xianghuan Xie Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
  • Guangzhi Chen Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan

DOI:

https://doi.org/10.11152/mu-4610

Keywords:

contrast-enhanced ultrasound, diagnosis, meta-analysis, renal masses

Abstract

Aim: This systematic review and meta-analysis was designed to evaluate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in distinguishing renal cancers from benign renal masses.

Material and methods: Meta-regression evaluated the sources of heterogeneity across studies and subgroup analyses for individual clinical classifications were conducted. Subgroup diagnostic performance for solid vs. cystic masses was also performed. The methodological quality evaluation was performed using the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2). Publication bias was assessed using the Begg funnel plot and Egger’s test.

Results: Thirty-six articles involving 4,530 renal masses (3,221 malignant, 1,309 benign) were included in the analysis. The pooled sensitivity, specificity, PLR, NLR, and DOR were 0.94 (0.91–0.96), 0.85 (0.79–0.89), 6.24 (4.54–8.56), 0.07 (0.04–0.11), and 89.46 (51.66–154.94), respectively. The accuracy was 0.95 (0.93–0.97). I2 values of sensitivity (I2=95.91%) and specificity (I2=80.43%) were both >50%. Subgroup analyses demonstrated that CEUS had higher sensitivity for cystic renal masses than solid renal masses (0.99 vs. 0.88), but lower specificity (0.80 vs. 0.87). No publication bias was found (p=0.123).

Conclusion: This meta-analysis demonstrated that CEUS could be an excellent tool for differentiating between malignant and benign renal masses, particularly for cystic renal masses.

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Published

2026-09-23

Issue

Vol. 28 No. 3 (2026)

Section

Reviews

License

All rights are reserved to the Medical Publishing House of the „Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca; no parts of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the permission of the editor.

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