Objective To evaluate the diagnostic performance of the Bosniak 2019 classification system CT features for benign and malignant renal cystic lesions.Methods Clinical information and CT images of 79 patients with renal cystic lesions who had pathology were collected retrospectively.The 79 lesions were analyzed by two physicians using the 2019 version of the Bosniak classification system to evaluate their CT imaging features,which were compared to pathological find-ings.ICC was used to evaluate the interobserver agreement of the measured features.The chi-square test,independent sam-ples t-test,and Mann-Whitney U test were used to compare the differences in clinical information and imaging features of pa-tients with benign and malignant lesions.The ROC curves were plotted for each quantitative feature,and the diagnostic effi-cacy between the different features was compared using the Z test.Results The differences in the maximum thickness of the wall or septa,the number of septa,the presence of irregular thickening and nodules,and the presence of calcification be-tween the two groups for benign and malignant lesions were statistically significant.In all lesions,the AUC of the maximum thickness of the cyst wall and septa was 0.925,which was statistically higher than using the number of septa alone and high-er than the combination of maximum thickness and the number of septa.However,the difference was not statistically signifi-cant.Conclusion The updated quantitative imaging features of the Bosniak 2019 classification system can reflect the be-nignity and malignancy of lesions,which has good clinical application.
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