Diagnostic accuracy of image-guided biopsies in small (&lt;4 cm) renal masses with implications for active surveillance: a systematic review of the evidence

Paterson, Catherine; Ghaemi, Joseph; Alashkham, Abduelmenem; Biyani, Chandra Shekhar; Coles, Bernadette; Baker, Lee D.; Szewczyk-Bieda, Magdalena; Nabi, Ghulam

doi:10.1259/bjr.20170761

Cited by 11 publications

(8 citation statements)

References 72 publications

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“…Core-needle biopsy is preferred over fine-needle aspiration. 19 Ultrasonography/CT-guided biopsy yields a high diagnostic performance (sensitivity 91-99.1%, negative predictive value 50-100%, diagnostic accuracy 85.5-97.1%, primary/secondary diagnostic yield 78-92.8%/86.1-94%), [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] and acceptable rates of major and minor complications (0-0.9% and 1.8-20.3%, respectively). [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] More rarely, MRI guidance has been used with reported sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 95.4%, 100%, 100%, 75% and 96%, respectively.…”

Section: Diagnostic Imaging and Percutaneous Biopsymentioning

confidence: 99%

“…19 Ultrasonography/CT-guided biopsy yields a high diagnostic performance (sensitivity 91-99.1%, negative predictive value 50-100%, diagnostic accuracy 85.5-97.1%, primary/secondary diagnostic yield 78-92.8%/86.1-94%), [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] and acceptable rates of major and minor complications (0-0.9% and 1.8-20.3%, respectively). [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] More rarely, MRI guidance has been used with reported sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 95.4%, 100%, 100%, 75% and 96%, respectively. 35 Compared to standard ultrasonography/ CT guidance, MRI-guidance grants some intraoperative technical advantages including the high intrinsic SRMs conspicuity, even in cases of entirely endophytic tumours, and the real-time multiplanar imaging-guidance facilitating tumour targeting.…”

Section: Diagnostic Imaging and Percutaneous Biopsymentioning

confidence: 99%

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Is percutaneous image-guided renal tumour ablation ready for prime time?

Cazzato

Garnon

Marini

et al. 2020

The British Journal of Radiology

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In the last few decades, thermal ablation (TA) techniques have been increasingly applied to treat small localised renal cell carcinomas. Despite this trend, there is still an underuse of TA compared to surgery and a substantial lack of high-quality evidence derived from large, prospective, randomised controlled trials comparing the long-term oncologic outcomes of TA and surgery. Therefore, in this narrative review, we assess published guidelines and recent literature concerning the diagnosis and management of kidney-confined renal cell carcinoma to understand whether percutaneous image-guided TA is ready to be proposed as a first-line treatment.

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Section: Diagnostic Imaging and Percutaneous Biopsymentioning

confidence: 99%

Section: Diagnostic Imaging and Percutaneous Biopsymentioning

confidence: 99%

Is percutaneous image-guided renal tumour ablation ready for prime time?

Cazzato

Garnon

Marini

et al. 2020

The British Journal of Radiology

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“…Adverse events following intervention including surgery do not get as much attentions as drug errors, Macmillan and colleagues 6 report a diaphragmatic hernia following cryoablation of liver lesion. This should be an interest to those who practice image guided biopsies 7 and treatment of intra-abdominal conditions.…”

Section: Ghulam Nabimentioning

confidence: 99%

Impact of Covid-19 pandemic on healthcare delivery, socio-political and economics

Nabi

2020

Scott Med J

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“…However, intervention is not always possible, and has its own complications. Biopsy results may be inconclusive, especially in smaller tumours, and surgical treatment may be unnecessary due to the indolence of the mass [ 10 , 11 , 12 ]. As the number of incidentally detected renal lesions increases, less invasive and cost-effective methods to differentiate between benign and malignant tumours are required.…”

Section: Introductionmentioning

confidence: 99%

Small Renal Masses without Gross Fat: What Is the Role of Contrast-Enhanced MDCT?

et al. 2022

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Increased detection of small renal masses (SRMs) has encouraged research for non-invasive diagnostic tools capable of adequately differentiating malignant vs. benign SRMs and the type of the tumour. Multi-detector computed tomography (MDCT) has been suggested as an alternative to intervention, therefore, it is important to determine both the capabilities and limitations of MDCT for SRM evaluation. In our study, two abdominal radiologists retrospectively blindly assessed MDCT scan images of 98 patients with incidentally detected lipid-poor SRMs that did not present as definitely aggressive lesions on CT. Radiological conclusions were compared to histopathological findings of materials obtained during surgery that were assumed as the gold standard. The probability (odds ratio (OR)) in regression analyses, sensitivity (SE), and specificity (SP) of predetermined SRM characteristics were calculated. Correct differentiation between malignant vs. benign SRMs was detected in 70.4% of cases, with more accurate identification of malignant (73%) in comparison to benign (65.7%) lesions. The radiological conclusions of SRM type matched histopathological findings in 56.1%. Central scarring (OR 10.6, p = 0.001), diameter of lesion (OR 2.4, p = 0.003), and homogeneous accumulation of contrast medium (OR 3.4, p = 0.03) significantly influenced the accuracy of malignant diagnosis. SE and SP of these parameters varied from 20.6% to 91.3% and 22.9% to 74.3%, respectively. In conclusion, MDCT is able to correctly differentiate malignant versus uncharacteristic benign SRMs in more than 2/3 of cases. However, frequency of the correct histopathological SRM type MDCT identification remains low.

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Diagnostic accuracy of image-guided biopsies in small (<4 cm) renal masses with implications for active surveillance: a systematic review of the evidence

Abstract: A comprehensive synthesis of literature on image-guided biopsies in SRMs using a different methodology and study design.

Cited by 11 publications

References 72 publications

Is percutaneous image-guided renal tumour ablation ready for prime time?

Is percutaneous image-guided renal tumour ablation ready for prime time?

Impact of Covid-19 pandemic on healthcare delivery, socio-political and economics

Small Renal Masses without Gross Fat: What Is the Role of Contrast-Enhanced MDCT?

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