E5390. Renal Cysts: A New Shift to the Bosniak Criteria
  1. Adriana Perez; No Affiliation
  2. Eduardo Acosta Pumarejo; No Affiliation
  3. Claudia Muns; No Affiliation
With increase in age, renal cysts become increasingly common, accounting for a frequently encountered renal pathology on radiographic imaging. The newest guideline proposed for radiological classification of cystic renal masses is Bosniak Classification, version 2019. Many pitfalls of the original Bosniak classifications are addressed and improved in this version, including a more specific characterization of what is considered suspiciously malignant versus a benign lesion, clear definitions of each characteristic to provide greater accuracy in reports and decrease interobserver variability among radiologists, and introduce the importance of MRI and US as tools for diagnosing certain cystic renal masses. As radiologists, we should diligently become up to date on this reporting system revision, as it will provide patients with a more accurate diagnosis on a larger span of radiological studies including CT, MRI, and US (on a limited basis).

Educational Goals / Teaching Points
Review the latest update on the Bosniak classification of cystic renal masses and highlight differences based on the previous version. Define terminology used in this updated classification. Review each Bosniak class with radiological examples on CT, ultrasound (US), and MRI. Discuss management based on each classification.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will review the updated Bosniak classification and stratify cystic renal masses’ risk of malignancy through its imaging characteristics on radiological studies including CT, MRI, and US. Furthermore, we will define the standard descriptors used in each category including thickness of walls and septa, the number of septa, presence of nodules, and incompletely characterized lesions, among others.

This educational exhibit will demonstrate the advantages of using the newest Bosniak criteria for stratification and identification of potential malignancies. This review will help standardize classification of cystic renal masses more efficiently among radiologists and help urologists make clear-cut decisions based on Bosniak classification. We will present key images on all modalities to represent each category as well as diagrams to portray each descriptor used for classification. After viewing our educational exhibit, the reader should be able to efficiently recognize the newest classification of cystic renal masses.