Risk Assessment of Incidentally Detected Complex Renal Cysts in Children: Potential Role for a Modification of the Bosniak Classification
Bibliographic record
Abstract
PURPOSE: Incidentally detected complex renal cysts in children are a rare but worrisome occurrence due to the perceived potential risk of malignancy. We examined the natural history of such cysts in a cohort of children. MATERIALS AND METHODS: We obtained access to a database containing all radiology reports generated at a single institution from 1996 to 2004. We used key words to limit our search, subsequently reviewing charts and images to confirm the diagnosis of a complex renal cyst and to collect clinical data. Cases were categorized according to a modification of the Bosniak classification, using ultrasound in most patients and computerized tomography or magnetic resonance imaging when available. RESULTS: Complex renal cysts were identified in 39 children. Mean patient age at presentation was 7 years. Mean cyst size was 1.6 cm. A total of 18 cases diagnosed by ultrasound only were observed with serial imaging. Additional contrast enhanced computerized tomography or magnetic resonance imaging was performed in 21 of 39 patients (54%). Surgical resection was performed in 5 patients and pathological evaluation revealed benign cyst in 3 (modified Bosniak class II in 2 patients and class III in 1) and renal cell carcinoma in 2 (III in 1 and IV in 1). All other patients had modified Bosniak class II cysts, which remained essentially unchanged during a mean followup of 26.8 months (range 9 to 70). CONCLUSIONS: While not validated in children, our data suggest the modified Bosniak classification appears useful as a guideline to direct the management of complex renal cysts in the pediatric population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".