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CT-Guided Biopsy for the Diagnosis of Renal Tumors Before Treatment with Percutaneous Ablation

¹ Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC.
² Present address: Department of Radiology, University of Utah Health Sciences Center, 30 North 1900 East #1A071, Salt Lake City, UT 84132-2140.
³ Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC.
⁴ Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC.
⁵ Division of Urology, University of Utah Hospital and Clinics, Salt Lake City, UT.

OBJECTIVE. Percutaneous thermal ablation is an emerging technique in the management of renal cell carcinoma (RCC), with greatest efficacy in tumors 3 cm. The purpose of this retrospective study was to evaluate the role and utility of pretreatment CT-guided biopsy in patients referred for percutaneous thermal ablation of renal tumors.

CONCLUSION. Less than 5% of samples in our study were benign, and 11.8% were nondiagnostic. Biopsy in smaller lesions was less accurate; therefore biopsy is less useful for these renal lesions. Because fine-needle aspiration (FNA) has higher sensitivity than core biopsy, an appropriate algorithm may be to begin with FNA and reserve core biopsy for cases in which an onsite cytotechnologist is unavailable or deems the sample of inadequate cellularity.

Keywords: ablation • biopsy • CT • oncology • percutaneous ablation • renal disease

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