Comparison of the Histologic Accuracy of Needle Biopsy Before and After Renal Cryoablation: Laboratory and Initial Clinical Experience

Comparison of Two Core Biopsy Techniques Before and After Laparoscopic Cryoablation of Small Renal Cortical Neoplasms

“…These results contradict the findings of our previous pilot study, which found no difference in diagnostic accuracy for samples taken pre- vs. postcryoablation (70% for both). 11 A likely explanation for this discrepancy is the very small sample size of our pilot study, which was likely insufficient to detect a significant difference across sampling time points.…”

“…Previously, we evaluated the histologic accuracy of needle core biopsy before and after renal cryoablation. 11 Diagnostic accuracy of both pre- and postcryoablation sampling was 70%. In a separate pilot evaluation, we evaluated the accuracy of 2 different biopsy techniques (standard vs. modified) at determining tumor histopathology during renal cryoablation.…”

“…As cryoablation and RFA have distinctly different ablation mechanisms, we previously evaluated and demonstrated the feasibility of postcryoablation biopsy in the porcine setting. 11 …”

“…In a porcine pilot study, we demonstrated the feasibility of a postablative biopsy protocol in an effort to optimize the oncologic safety and address the concern with tumor seeding, which has served as a real barrier for many clinicians, preventing the universal practice of intraoperative biopsies of RCNs. 11 Theoretically, postablation biopsy should reduce the risk of tumor seeding, given that the tissue in question would not be viable prior to extraction through the needle tracts. In addition, a second pilot study in our laboratory compared the accuracy of 2 different biopsy techniques at detecting renal tumor architecture during cryoablation and concluded that a modified technique (Figure 1) 12 was as equally safe and feasible as the currently used standard technique.…”

Histopathologic Findings of Small Renal Tumor Biopsies Performed Immediately After Cryoablation Therapy

“…Nonetheless, SRTs have a higher falsenegative rate. 17,18 Regardless, the patients are closely followed by CT scan. Kramer et al 21 have also suggested in their study (renal biopsies before cryoablation) using a three-core biopsy strategy, which resulted in an 11% increase in cancer yield and a 12% reduction in the nondiagnostic rate.…”