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Renal Cystic Mass Evaluation (Bosniak v2019)

Renal Cystic Mass Evaluation (Bosniak v2019): Cystic Renal Mass on CT/MRI → Solid Enhancing Component? → Bosniak IV. Based on Bosniak Classification v2019.

Interactive Decision Tree

Mini Map

Algorithm Steps

  1. ▶
    Start

    Cystic Renal Mass on CT/MRI

    1. ◆
      Decision

      Solid Enhancing Component?

      1. ■
        End

        Bosniak IV

        ~90% malignancy - surgery recommended

      2. ◆
        Decision

        Septa/Wall Characteristics

        1. ■
          End

          Bosniak I: Simple Cyst

          <1% malignancy, no follow-up

        2. ■
          End

          Bosniak II: Minimally Complex

          <1% malignancy, no follow-up

        3. ■
          End

          Bosniak IIF: Follow-up

          ~5-10% malignancy, 6-12mo imaging

        4. ■
          End

          Bosniak III: Indeterminate

          ~50% malignancy, surgery or surveillance

Guideline Source

Bosniak Classification v2019

DOI: 10.1148/radiol.2019182646View Guideline

Clinical Safety Information

Clinical Decision Support — Not a Substitute for Clinical Judgment

Individual patient factors may require deviation from these recommendations.

Known Limitations

  • Applies to cystic masses only
  • 2019 version differs from 1986 original
  • MRI may change CT Bosniak category

Applicable Regions

USAUUKEU

EU: EAU guidelines similar approach

US: AUA guidelines incorporate Bosniak

Version 1Next review: 2028-01-01

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Frequently Asked Questions

What is the Renal Cystic Mass Evaluation (Bosniak v2019)?

The Renal Cystic Mass Evaluation (Bosniak v2019) is a diagnostic clinical algorithm for Radiology. It provides a structured decision tree to guide clinical decision-making, based on Bosniak Classification v2019.

What guideline is the Renal Cystic Mass Evaluation (Bosniak v2019) based on?

This algorithm is based on Bosniak Classification v2019 (DOI: 10.1148/radiol.2019182646).

What are the limitations of the Renal Cystic Mass Evaluation (Bosniak v2019)?

Known limitations include: Applies to cystic masses only; 2019 version differs from 1986 original; MRI may change CT Bosniak category. Individual patient factors may require deviation from these recommendations.

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