CEUS Outperforms CT and MRI in Detecting Residual Kidney Tumors, New Study Shows

Contrast-enhanced ultrasound (CEUS) demonstrated perfect accuracy in detecting residual or recurrent kidney tumors following kidney-sparing surgery, significantly outperforming both contrast-enhanced CT and MRI, according to findings presented at the 39th annual International Bubble Conference in Chicago.

The multicenter study, led by Dr. Richard G. Barr, professor of radiology at Northeast Ohio Medical University and officer of the International Contrast Ultrasound Society, evaluated 193 kidney lesions across 188 patients over a six-year period. Results showed that CEUS achieved 100% sensitivity and specificity, making it the most reliable follow-up imaging option for patients undergoing nephron-sparing procedures.

“Nephron-sparing surgeries are increasingly common in the treatment of renal cell carcinoma, but recurrence can occur even years after the procedure,” Dr. Barr explained during the conference. “This makes accurate and safe long-term monitoring essential—and CEUS has proven to be a superior tool for this purpose.”

CEUS works by injecting ultrasound contrast agents (UCAs) into the bloodstream, enabling real-time visualization of abnormal microvascular blood flow patterns. Unlike contrast materials used in CT and MRI, UCAs do not contain iodine or gadolinium and are not nephrotoxic, making them safer for patients with impaired kidney function or those at risk of allergic reactions.

In addition to its safety advantages, CEUS is less expensive than both MRI and CT. The technology eliminates patient exposure to ionizing radiation, while simultaneously improving diagnostic accuracy for detecting residual or recurrent cancer cells after treatment. “CEUS not only avoids the risks associated with CT and MR contrast agents but also delivers better diagnostic results,” Dr. Barr noted.

Globally, CEUS is already widely used in oncology, cardiology, and gastroenterology. Clinicians rely on it to characterize cancers, evaluate vascular disease, monitor chronic gastrointestinal conditions, and assess therapeutic response. Its ability to identify disease through microvascular changes makes it a powerful imaging alternative in multiple clinical contexts.

The implications for kidney cancer care are significant. Renal cell carcinoma is the 13th leading cause of cancer-related deaths worldwide, and timely detection of recurrence is critical to improving survival. For patients with limited options due to renal impairment, CEUS provides a safe, accurate, and accessible alternative to traditional imaging.

Currently, four UCAs are approved in different parts of the world: Sonovue (marketed as Lumason in the U.S.) by Bracco; Definity by Lantheus; and Optison and Sonazoid by GE HealthCare. Their availability ensures CEUS can be widely deployed in clinical practice, expanding access to this safer and more effective imaging modality.

The study underscores the growing importance of CEUS in cancer follow-up care and highlights its potential to replace CT and MRI as the preferred imaging technique in patients undergoing nephron-sparing procedures. As Dr. Barr emphasized, “CEUS represents a clear step forward in detecting cancer recurrence safely, efficiently, and cost-effectively, while reducing the burden on both patients and healthcare systems.”