Bosniak Classification for Renal Cysts

When it activates

Scribeable activates a calculator from the encounter. The Bosniak Classification for Renal Cysts can activate when the transcript or pasted chart context documents any of these:

• Renal cyst evaluation
• Complex renal cyst classification
• Kidney cyst characterization
• Renal mass incidentaloma workup
• Cystic renal lesion management

Inputs the note needs

1 input. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.

Scoring

Class I: Simple cyst — thin wall, no septa/calcifications/solid components, water density, non-enhancing. Class II: Minimally complicated — few thin septa, fine calcification, <3cm homogeneous high-attenuation lesions. Class IIF: More complex than II but not clearly III — multiple thin septa, minimal smooth thickening, thick/nodular calcification, >3cm high-attenuation lesions (requires follow-up). Class III: Indeterminate — thickened irregular/smooth septa or wall with measurable enhancement. Class IV: Clearly malignant — distinct enhancing soft-tissue component.

Interpretation

Class I: Benign — no follow-up. Class II: Benign — no follow-up needed. Class IIF: ~5% malignancy — imaging follow-up at 6 months, 1 year, then annually for 5 years. Class III: ~50% malignancy — surgical excision or active surveillance. Class IV: ~85-100% malignancy — surgical management (partial/radical nephrectomy). 2019 revision consolidates features and emphasizes MRI over CT for indeterminate lesions.

Evidence

Sources carried in Scribeable's citation registry for this calculator; guideline version: Bosniak 2019.

• Silverman SG et al. Bosniak Classification of Cystic Renal Masses, Version 2019Silverman et al. (Bosniak v2019) · 2019 · Consensus · link last verified 2026-03-28

How Scribeable handles it in the note

When an encounter activates the Bosniak Classification for Renal Cysts (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.

The score is computed in code from the resolved inputs, not recalled by the language model. A stated Bosniak Classification for Renal Cysts value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.

Classified as a staging or classification system: activated strictly, because a wrong stage on the wrong patient is a documentation hazard.

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Can activate in: Surgery, Urology, Radiology & Interventional Radiology.