HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Maturen, K. E. Articles by Wood, D. P. Search for Related Content PubMed PubMed Citation Articles by Maturen, K. E. Articles by Wood, D. P., Jr. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Renal Mass Core Biopsy: Accuracy and Impact on Clinical Management

¹ Department of Radiology, UH B1D407, University of Michigan Hospitals, Ann Arbor, MI.
² Present address: Department of Radiology, Stanford Hospital and Clinics, 300 Pasteur Dr., H1307, Stanford, CA 94305-5105.
³ Department of Diagnostic Radiology, William Beaumont Hospital, Royal Oak, MI.
⁴ Department of Surgery-Urology, University of Michigan Hospitals, Ann Arbor, MI.

OBJECTIVE. The objective of our study was to determine the accuracy of imaging-guided percutaneous renal mass biopsy and its impact on clinical management.

MATERIALS AND METHODS. With institutional review board approval, we retrospectively reviewed imaging-guided renal biopsies performed by radiologists at our institution between February 1999 and July 2005. Patient records, pathology reports, and imaging studies were reviewed. Concordance of biopsy diagnosis and follow-up data was assessed. Significant impact on clinical management was determined in collaboration with two experienced urologists and was defined as a change from no therapy to therapy, including surgery, tumor ablation, chemotherapy, or radiation.

RESULTS. Two hundred seventy-six renal biopsies were performed during the study period. Of these, 123 were random biopsies and fine-needle technique was used for one; these 124 were excluded. One hundred fifty-two renal mass biopsies were performed using coaxial 18-gauge core needle technique in 125 patients (55 women, 70 men; average age, 60 years; range, 28-90 years). There were two (1.3%) postprocedural hematomas (one [0.7%] requiring blood transfusion) and one (0.7%) delayed renal pseudoaneurysm attributed to biopsy. No tumor seeding was identified. In 85 biopsies (56%), malignant neoplasm was found, 61 biopsies (40%) yielded benign findings, and six (4%) were nondiagnostic. The sensitivity for malignancy was 97.7%; specificity, 100%; positive predictive value, 100%; and negative predictive value, 100%. At least 92 (60.5%) biopsy results significantly impacted clinical management.

CONCLUSION. Imaging-guided percutaneous core needle biopsy of renal masses is safe and highly accurate. Tissue diagnosis alters clinical decision making in a majority of the cases and may allow a number of unnecessary nephrectomies to be avoided.

Keywords: core biopsy • kidney • renal disease • renal mass

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S. A O'Keeffe, S. McNally, and M. T Keogan Investigating painless haematuria BMJ, July 9, 2008; 337(jul09_3): a260 - a260. [Full Text]

				S. R. Prasad, V. R. Surabhi, C. O. Menias, A. A. Raut, and K. N. Chintapalli Benign Renal Neoplasms in Adults: Cross-Sectional Imaging Findings Am. J. Roentgenol., January 1, 2008; 190(1): 158 - 164. [Abstract] [Full Text] [PDF]

				P. Tombesi, M. Catellani, and S. Sartori Renal Mass Core Biopsy Am. J. Roentgenol., September 1, 2007; 189(3): W168 - W168. [Full Text] [PDF]