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Micro bubbles sonogram

Trisa1795
Posts: 9
Joined: Aug 2018

Hello everyone.  I finally saw the urologist today and while I went int expecting him to schedule surgery, he wants me to have an microbubble sonogram. Had anyone had this done and did the results change anything?  

Doctor said that my ultrasound showed mass had separations with thin walls but the CT scan said thick walls.  He also said he would classify mass as a Bosnian 3. So, I don’t understanding what this test could change Except maybe ”a wait and see” instead of surgery right away?!?

i look forward to your replies. 

Trisa

icemantoo's picture
icemantoo
Posts: 3208
Joined: Jan 2010

Trisa,

 

 

This is the first time I have heard of this test and have not seen it on this board. The google explanations were all above my paygrade. Let us know if it helps in your diagnosis.

 

 

icemantoo.

Manufred's picture
Manufred
Posts: 239
Joined: May 2017

All new to me too but Google is a worthy teacher.

Contrast Enhanced Ultra-Sound uses microbubbles injected into the blood to increase what US can tell them.  It seems to be a recent improvement over CT and avoids the stress on the kidneys of the CT contrast agent which is chemical.

The research around CEUS appears to be centred on improving the accuracy of Bosniak (not Bosnian) rankings for kidney cysts risk of cancer, so I would encourage this.

Ultimately if the risk looks too great they will probably do either a CT or a bioposy to confirm, so I suggest let it happen.  I can't see that you are in immediate danger.

Best Wishes,

Fred

Trisa1795
Posts: 9
Joined: Aug 2018

Thanks Fred!  Thanks for the research.  It is nice to know that my doctor and hospital are ontop of the research and testing.  He explained that a biopsy isn't a very good test for this type of (possible) cancer because the needle may take a sample from a septation that isn't cancer, yet the other septations may have it.  (I hope I used the right terminology on that).  

I am able to have the test very quickly but then seeing his partner who would do surgery if needed is another story.  It may be a month and as everyone knows- the waiting is the worst.  

So, I guess we will see if this test changes what would definitely be surgery.   

PS... dumb auto correct- I did mean Bosniak.  LOL

lobbyist0724's picture
lobbyist0724
Posts: 383
Joined: Sep 2016

Hi Trisa,

It seems that you are having a Cystic mass with thick wall and multiple septations and is classified as a Bosniak 3 cystic mass after CT w/wo contrast. I also have a cystic mass that was Bosniak category 3. You didn't mention about the size, my surgeon told me that 3 cm is the cut off where surgery is recommended if the mass is over 3cm.

Also, I am from Canada, below is a link to the latest guideline for cystic renal mass from Canadaian Urology Association. It just got updated last year, so the information is very recent. As suggested in the guideline most of these cystic lesions have low metastatic potential. So don't worry too much and take care.

https://www.cua.org/themes/web/assets/files/cua_guideline_on_the_management_of_cystic_renal_lesions.pdf

Hope this help.

Carmen

Trisa1795
Posts: 9
Joined: Aug 2018

Thanks so much for this website.  I am going to read it now.  My mass is 2.4 x 3.2 x 2.3 which is still small.  It was found incedentally after having back surgery in July.  I was still in so  much pain a few weeks out that my surgeon did a follow up MRI and that is where it was reported.  (It was actually on the MRI that I had before surgery in March but the radiologist failed to report it.)

I will update you this week as to the results. 

Kat23502's picture
Kat23502
Posts: 179
Joined: Feb 2016

Cintraday enhanced ultrasound (CEUS) is a technique that has been used regularly in other areas but has really started emerging as of late for renal imaging. The research has shown it to be somewhat better than even CT in determining the characteristics of complex cystic renal masses. When is cyst has thing septations that don’t have blood flow they are considered to have a fairly high likely hood of being benign. When those septations are thicker and/or contain blood flow, they are much more likely to be malignant or undergo malignant changes. So, it sounds like your doctor is using the CEUS to better determine the treatment plan. It is a very safe and quick test that can offer quite a bit of useful information. We are using it more and more now and as I teach my new students, I suspect that in the near future we will see it ordered instead of CT for complex cystic renal masses.

Trisa1795
Posts: 9
Joined: Aug 2018

Thank you so mucH.   That was an excellent explanation. I really appreciate it  

 

 

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