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RadiologyDiagnostic
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.
Pathway Overview
8 steps
Algorithm Steps
8 total
01Start 02Decision Solid Enhancing Component?
03End Bosniak IV
~90% malignancy - surgery recommended
04Decision Septa/Wall Characteristics
05End Bosniak I: Simple Cyst
<1% malignancy, no follow-up
06End Bosniak II: Minimally Complex
<1% malignancy, no follow-up
07End Bosniak IIF: Follow-up
~5-10% malignancy, 6-12mo imaging
08End Bosniak III: Indeterminate
~50% malignancy, surgery or surveillance
Guideline Source
Bosniak Classification v2019
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
Next steps
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Related Resources
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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