Bosniak classification
Bosniak Classification of Cystic Renal Masses
The Bosniak classification stratifies the malignancy risk of cystic renal masses into categories (I, II, IIF, III, IV) that map to management, from “ignore” to “resect.” It is a perennial search at the reporting workstation. Version 2019 formally incorporates MRI, tightens definitions of walls, septa, and enhancement to cut interreader variability, and deliberately shifts emphasis toward specificity — the intended effect being fewer benign cysts pushed into higher classes and fewer unnecessary operations. A clean “old vs new” story from 2005 to 2019.
Version history & what changed
- Version 20192019Current
Formally incorporates MRI, tightens definitions of walls, septa and enhancement to cut interreader variability, and shifts emphasis toward specificity — fewer benign cysts pushed into higher classes and fewer unnecessary operations.
- 2005 update2005
Israel & Bosniak refinements clarifying the IIF category and follow-up recommendations for minimally complex cysts.
- Original Bosniak classification1986
Established categories I–IV linking cystic renal mass complexity to malignancy risk and a management pathway.
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Resources & links
- referenceBosniak v2019 (Radiology 2019)
RadPigeon is an independent radiology news digest and is not affiliated with or endorsed by Bosniak; v2019 by Silverman et al.. “Bosniak classification” is a trademark of its owner and is named here only to refer to the system. Always consult the official source for the exact, current criteria.