The Role of Percutaneous Renal Biopsy in the Management of Small Renal Masses

Wang, Rou; Li, Amy Y.; Wood, David P.

doi:10.1007/s11934-010-0149-x

Cited by 17 publications

(28 citation statements)

References 54 publications

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“…The sensitivity and specificity of image‐guided renal biopsies for diagnosis of malignancy have previously been reported to be 80–92% and 83–100%, respectively . Our series confirms this previously reported data, yielding 91% sensitivity with an overall accuracy of 85.5%.…”

Section: Discussionsupporting

confidence: 90%

Image‐guided biopsy of small renal masses in the era of ablative therapies

et al. 2012

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Abbreviations & Acronyms CT = computed tomography MRI = magnetic resonance imaging NHL = non-Hodgkin's lymphoma RCC = renal cell carcinoma SD = standard deviation SRM = small renal masses US = ultrasonography Objective: To further evaluate the accuracy, safety, and impact of image-guided renal biopsies on clinical decision making and management of the indeterminate small renal masses. Methods: A total of 145 patients (males 99, females 46) with small renal masses suspicious for malignancy were evaluated during the study period. The patients' mean age was 67.2 (Ϯ 11.6) years. Computed tomography guided biopsies were carried out in all cases by an experienced interventional radiologist. An experienced genitourinary pathologist reviewed all pathological specimens. Patients' demographic characteristics, tumor histology and subsequent intervention, as well as periprocedural morbidities were recorded and analyzed. Results: A total of 145 renal biopsy procedures were carried out. The small renal masses mean size was 2.4 Ϯ 1.1 cm. Biopsy was diagnostic in 126 (86.9%) cases and non-diagnostic in 19 (13.1%) cases. Of diagnostic biopsies, 107 (84.9%) were malignant, 84.1% of which were primary renal cell carcinoma. Histological subtyping and grading of tumor was possible in 100% and 52.2% of renal cell carcinomas, respectively. The major renal cell carcinoma subtype was clear cell (63.3%) followed by papillary (24.4%) and chromophobe (8.8%). Repeat biopsy was carried out in nine of 19 non-diagnostic cases, and diagnosis was possible in 66.7%. Sensitivity of percutaneous renal biopsy was 91%, and its accuracy was 85.5%. Overall, patients' age, sex, tumor size, and location were not related to non-diagnostic biopsy results and/or tumor pathology. No cases of hemorrhage, seeding of biopsy tract, infection or mortalities were observed. Conclusions: Our findings showed that image-guided biopsy of indeterminate small renal masses is safe and can provide the correct diagnosis with a high degree of accuracy. Thus, this procedure can play an important role in establishing a histopathological diagnosis before treatment of enhancing small renal masses with ablative technologies. Furthermore, repeat biopsy can alter the clinical management of non-diagnostic biopsies.

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Section: Discussionsupporting

confidence: 90%

Image‐guided biopsy of small renal masses in the era of ablative therapies

et al. 2012

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“…New biopsy techniques decrease the risk of tumour seeding, and overall morbidity is low. Diagnostic sufficiency and accuracy of RMB are now much higher in large-volume, experienced centres [56, 57]. Experienced users can achieve accurate diagnosis in over 90%.…”

Section: Imaging Parameters Of Renal Massesmentioning

confidence: 99%

“…Another study group concluded that percutaneous renal needle core biopsy has an acceptable sensitivity and specificity in the diagnosis of renal masses. The major limitation of percutaneous core biopsy is the technical failure that leads to insufficient material for accurate diagnosis [56, 57]. …”

Section: Imaging Parameters Of Renal Massesmentioning

confidence: 99%

Assessment and characterisation of common renal masses with CT and MRI

et al. 2011

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ObjectiveOwing to the widespread use of abdominal imaging studies the detection rate of solid renal masses has increased, and an accurate characterisation of imaging features of renal masses has become more essential for case management.Method and resultsMR imaging (MRI) and computed tomography (CT) are frequently used modalities for detection and differentiation of renal masses. This article gives a review of imaging characteristics of benign and malignant renal masses, discussing their appearance in CT and MR imaging. Advanced MR techniques like diffusion-weighted imaging and apparent diffusion coefficient (ADC) mapping, which have shown promising results in the differentiation between benign and malignant renal lesions, will be introduced.ConclusionMRI and CT are useful in the characterisation and estimation of the prognosis for renal masses.

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“…70 The overall accuracy of renal biopsy has been shown to be dependent on the size of the mass. 71 Sensitivity for malignancy was 84%, 97%, and 87% for masses <3 cm, 4-6 cm, and >6 cm, respectively. 72 Negative predic tive values were 60%, 89%, and 44% for masses <3 cm, 4-6 cm, and those >6 cm, respectively.…”

Section: Misdiagnosis In Kidney Biopsiesmentioning

confidence: 92%

Misdiagnosis of clear cell renal cell carcinoma

Valera

Merino

2011

Nat Rev Urol

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Clear cell renal cell carcinoma (RCC) represents the most common histological subtype of malignant kidney tumors. Based on symptoms alone, clear cell RCC is indistinguishable from other histological classes of RCC unless the tumor is present in the context of an RCC syndrome. Histopathological examination is, therefore, important to accurately identify clear cell RCC. Clear cell RCCs have characteristic morphological criteria; these tumors can be easily identified upon typical presentation, but diagnosis can be challenging when tumor cell pattern is unusual or when availability of tissue samples is limited. In this Review, the clinical, radiological and pathological characteristics of clear cell RCCs are described, as well as the potential tumors that can be confused with clear cell RCC and need to be considered in the differential diagnoses. Finally, the importance of an accurate diagnosis is highlighted in the context of the increasing use of preoperative tissue sampling and the prevalence of clear cell tumors associated with hereditary syndromes, which could have different therapeutic and prognostic implications for patients and their families.

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The Role of Percutaneous Renal Biopsy in the Management of Small Renal Masses

Cited by 17 publications

References 54 publications

Image‐guided biopsy of small renal masses in the era of ablative therapies

Image‐guided biopsy of small renal masses in the era of ablative therapies

Assessment and characterisation of common renal masses with CT and MRI

Misdiagnosis of clear cell renal cell carcinoma

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