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ABSTRACT |
Monday, May 1, 1:30 PM–3:30 PM
Abstracts 066–077
Moderators: Nilesh H. Patel, MD and Thomas R. Burdick, MD
1:30 PM
066. Gross Hematuria after Radiofrequency Ablation of the Liver using the Berchtold/Integra LifeSciences Device
Kachura J.R.1*; Hanson J.M.1; Kirby J.M.1; Ho C.S.1; Cole E.H.2; Richardson R.M.2; 1. Medical Imaging, Toronto General Hospital, Toronto, Ontario, Canada; 2. Nephrology, Toronto General Hospital, Toronto, Ontario, Canada.
Address correspondence to J.R. Kachura (john.kachura{at}uhn.on.ca)
Objective: To evaluate the incidence, outcome, and etiology of gross hematuria after radiofrequency ablation (RFA) of hepatoma using the Berchtold/Integra LifeSciences device.
Materials and Methods: Medical records of 18 patients with 38 hepatomas treated with 21 RFA procedures using the Berchtold/Integra LifeSciences monopolar system (a straight needle electrode utilizing saline perfusion) were retrospectively reviewed. All procedures were performed percutaneously using combined ultrasound and CT guidance, under conscious sedation, on an outpatient basis. Mean maximum tumor diameter was 2.0 cm (range 0.6–4.5 cm) and mean ablation zone diameter was 4.2 cm (range 2.4–7.6 cm).
Results: Painless gross hematuria resolving within 36 hours was noted after 9 procedures (43%) in 7 patients (39%). Dipstick urine testing in patients with hematuria was strongly positive for blood, positive for protein, and negative for myoglobin, bilirubin, and urobilinogen. Microscopic urinalysis of hematuria samples showed no red blood cells and no casts. Analysis of serum in these patients post-RFA revealed the presence of free hemoglobin. There was no alteration in renal function. When patients and procedures were compared in 2 groups, hematuria vs. no hematuria, there was no significant difference (p > 0.05) in ablation zone diameter, energy deposited, and infused saline volume. Patients with hematuria had a greater number of RFA cycles (p = 0.03).
Conclusion: Gross hematuria, likely due to the release of free hemoglobin from intravascular hemolysis, is a common minor complication of liver RFA with a perfusion electrode.
067. Pain Following Percutaneous Liver Biopsy: Does Approach Matter? A Randomized Trial Comparing Subcostal versus Intercostal Approach
Tan K.T.*; Rajan D.K.; Kachura J.R.; Hayeems E.; Simons M.E.; Ho C.S.; Department Medical Imaging, University Health Network, Toronto, On, Canada.
Address correspondence to K.T. TAN (kongteng.tan{at}uhn.on.ca)
Objective: To compare the pain levels as measured by visual analogue pain score (VAS) and analgesic requirement between intercostal versus anterior subcostal ultrasound guided liver biopsy.
Materials and Methods: Seventy consecutive patients were randomized to intercostal (n = 33) or subcostal (n = 37) approach. The groups were matched with regards to baseline characteristics: mean age 44; range 20 to 70, 43 male; 27 female, and hepatitis C 69%, hepatitis B 16% and others 15%. The VAS was obtained immediately after biopsy and hourly for four hours until the patients were discharged. Analgesic requirement and post procedure complications were documented.
Results: No significant difference in the VAS between the groups. The average VAS was below 10 (scale of 100). 36.4% of patients in the intercostal group required additional analgesia post biopsy in comparison to 27.0% in the subcostal group (P > 0.05). One patient in the intercostal group refused to have future follow-up biopsy even if clinically indicated in comparison to no patients in the subcostal group. No differences in diagnostic sample or major complications in either group.
Conclusion: Ultrasound guided percutaneous liver biopsy is a well-tolerated procedure with minimal patient's discomfort. The location of the biopsy does not influence the outcomes of the procedure.
068. Impact of FDG-PET CT Imaging on The Utility of Image Guided Percutanous Biopsies of Non Thoracic Lesions
Uppot R.N.*; Sahani D.V.; Gervais D.A.; Blake M.A.; Hahn P.F.; Mueller P.R.; Division of Abdominal Imaging; Department of Radiology, Massachusetts General Hospital, Boston, MA.
Address correspondence to R.N. Uppot (ruppot{at}partners.org)
Objective: FDG-PET has always been to identify masses that are suspicious for neoplasm based on their metabolic characteristics. With the increase use of PETCT in abdominal imaging, GI interventional radiologists are now increasingly consulted for biopsy of thyroid or abdominal lesions which are "PET positive." Some of these "PET + "lesions are lesions that, prior to the advent of FDG-PET imaging, were not identified on CT imaging or were not felt to be suspicious based on their imaging characteristics or size. The purpose of this study is to review our one year experience of FDG-PET CT from an interventionalist's perspective. We reviewed all positive non chest PETCT cases which underwent image-guided biopsy over the course of one year.
Materials and Methods: Retrospective review of patients who has "PET+" lesions on FDG-PET CT study of the abdomen pelvis and thyroid who underwent image guided percutaneous biopsy in 2004 was performed. Demographics, method of biopsy, lesion location were identified. Pre-procedure diagnosis of the "PET positive" lesions was compared with final pathological results.
Results: Between 
and 2/05, 38 cases were referred with
history of "PET + lesion." Average age: 55.97 (range 17–86
years old). 17 males and 21 females. Majority cases underwent image-guidance
with CT (71%) versus US (29%). Organs biopsied included
abdominal/retroperitoneal and inguinal nodes (23.4%), thyroid (15.7%), bone
(13.2%) adrenals (10.5%), liver (7.8%), and spleen, kidney, axillary/neck
nodes. Most biopsies were in patients with a known primary with suspected
metastasis (92%) and the remaining patients (7.8%) presented with no known
primary. Final pathological diagnosis confirmed malignancy in 68% of cases and
negative for malignancy in 31.5%. All cases (100%) with no known primary were
confirmed to be malignant.
Conclusion: Biopsies performed as a result of FDG PET CT imaging are primarily in patients with a known primary. Patients with no known primary tumor are also aided, with PETCT successfully (100%) identifying the area of malignancy as confirmed with image guided biopsy. Based on our study, even though a lesion is PET positive on PETCT imaging, there is a 31% chance that the lesion is not malignant.
069. Image-guided Biopsies and Aspirations of Pelvic Masses in Children
Okell J.; Amaral J.G.*; Connolly B.; Temple M.; John P.; Chait P.G.; Department of Diagnostic Imaging - Image Guided Therapy Centre, The Hospital For Sick Children, Toronto, ON, Canada.
Address correspondence to J.G. Amaral (joao.amaral{at}sickkids.ca)
Objective: To determine the accuracy, effectiveness and safety of performing ultrasound and CT guided pelvic biopsies or aspirations in children.
Materials and Methods: Thirty pelvic biopsies were performed on 28 children with the aid of ultrasound guidance (n = 30) and CT guidance (n = 2). Of these procedures, 28 were core biopsies and 2 were aspirations. The mean age of the children was 8.4 years (range: 1 month to 18 years). The needles used to obtain tissue samples were between 14 gauge and 21 gauge. The number of cores obtained for analysis ranged from 1 to 11 with a mean of 4.3. Institutional Research Ethics Board approval was obtained for this retrospective study.
Results: There were 19 malignant lesions and 8 benign lesions. The malignant masses included lymphoma (n = 5), Ewing's Sarcoma (n = 3), rhabdomyosarcoma (n = 3), neuroblastoma (n = 2), yolk sac carcinoma (n = 2), lipoblastoma (n = 1), small cell tumour (n = 1), teratoma (n = 1), and Wilm's Tumour (n = 1). The initial image-guided pelvic biopsies had a diagnostic accuracy of 89% (25/28).Three biopsies were inadequate. These biopsies were performed using a 16 or an18 gauge needle which provided 3 or 4 cores in each case. These 3 children underwent surgical biopsies which yielded tuberculosis, ganglioneuroma and lymphangioma, respectively. One patient experienced bloody discharge through the rectum. The remaining biopsies and aspirations were uneventful.
Conclusion: Image-guided percutaneous biopsy or aspiration of pelvic masses in children is an accurate and safe procedure. The minimal invasiveness and high diagnostic ability contribute to their success.
070. Percutaneous Image-guided Cryoablation of Solid Renal Tumors
Farrell M.A.*; Atwell T.; Callstrom M.; Charboneau W.; Reading C.; Lewis B.; Lee R.; Radiology, Mayo Clinic, Rochester, MN.
Address correspondence to M.A. Farrell (farrell.michael{at}mayo.edu)
Objective: The purpose of this study is to determine the safety and efficacy of percutaneous cryoablation in the treatment of the solid renal mass.
Materials and Methods: We performed a retrospective review of percutaneous renal tumor cryoablations performed at our institution from March, 2003, through early August, 2005. Forty tumors in 40 patients were treated in 40 sessions using combined CT- and ultrasound-guidance. The mean age of patients was 76 years (range, 53–92 years). Treatment success was defined by absence of discrete tumor enhancement at follow-up MRI or CT.
Results: Mean size for all 40 treated tumors was 3.4 cm (range, 1.5–7.2 cm). Nineteen tumors were 3 cm or larger. Nineteen tumors (47.5%) extended into the renal sinus fat. There were 5 significant complications (12.5%), including hemorrhage directly attributable to cryoablation in 3 patients. Thirty-nine of 40 (97.5%) cryoablation procedures were technically successful. With mean follow-up of 8.0 months (range, 1.2–18.4 months) in 27 patients, there has been no local tumor recurrence, equating with 100% local tumor control.
Conclusion: Our initial experience shows that percutaneous cryoablation using CT- and ultrasound-guidance is highly effective in the treatment of renal tumors. More long-term follow-up should further prove the efficacy of this technique.
071. Ultrasound-guided Liver Mass Biopsy: When is a Repeat Biopsy Needed?
Chintapalli K.*; Jones C.; Gujjarappa S.; EL Merhi F.; Dalrymple N.; Prasad S.; Freckleton M.; Radiology, UT Health Science Center, San Antonio, San Antonio, TX.
Address correspondence to K. Chintapalli (chintapalli{at}uthscsa.edu)
Objective: Purpose: The present study was conducted to determine the frequency and factors for re-biopsy of liver masses at a teaching university hospital.
Materials and Methods: Method and Materials: A retrospective review of the abdominal intervention database identified 265 ultrasound guided liver mass biopsies performed during a 54 month period from 2/1/2001 to 8/31/05. All patients had cross sectional imaging prior to the biopsy. Fifteen patients had repeat biopsies done in our series, ten within one month and five in 1–7months. Indications, needle size, complications and pathology reports were reviewed and tabulated. Eight of 15 had a known malignancy. First Biopsy specimen was non diagnostic in two patients; in two others additional tissue was needed for additional histology processing.
Results: Repeat liver mass biopsy was done in 6% [15 of 250] of patients in our series. Inadequate tissue was the reason in only 1% of patients. Repeat biopsy was successful in all cases and malignancy confirmed in 14. In one other case the initial and repeat biopsy yielded a benign diagnosis. Final diagnosis was carcinoma in 8, HCC in 4, lymphoma and Ewing's Sarcoma in one each. The reasons for failure to obtain a diagnosis can be due to sampling error and pathologist's difficulty to make a definite diagnosis of malignancy in well differentiated tumors.
Conclusion: Repeat ultrasound guided biopsy of liver masses is warranted in a small percentage of patients and permits pathological diagnosis in all cases.
072. The Efficacy of FDG Positron Emission Tomography to Assess the Amount of Tumor Destruction After Radiofrequency Ablation for Lung Tumors
Daly J.C.1*; vanSonnenberg E.2; Shankar S.3; Nair R.5; Morrison P.4; Silverman S.4; Tuncali K.4; van den Abbeele A.6; 1. Medicine, Newton-Wellesley Hospital, Newton, MA; 2. Radiology, St. Joseph's Medical Center, Phoenix, AZ; 3. Radiology, University of Massachusetts Medical Center, Worcester, MA; 4. Radiology, Brigham and Women's Hospital, Boston, MA; 5. Radiology, Cleveland Clinic, Cleveland, OH; 6. Radiology, Dana-Farber Cancer Institute, Boston, MA.
ddress correspondence to J.C. Daly (daly2b{at}hotmail.com)
Objective: CT-guided radiofrequency ablation (RFA) is a treatment used for patients with inoperable tumors or who are not good surgical candidates. Its use has been well established for hepatic malignant tumors, but few reports exist regarding its use for lung tumors. Positron emission tomography (PET) can detect the presence of certain malignant tumors with greater sensitivity than CT. We report our experience with PET scans to assess tumor residua in patients after treatment with RFA for lung tumor.
Materials and Methods: We identified patients who had lung tumors treated with CT-guided RFA who had PET scans both prior to RFA and following RFA. Comparison was made of the PET studies for each patient to assess for any change in the tumor activity after RFA. Ten patients (7 male, 3 female) underwent RFA treatment for lung tumor. Mean age was 72.5 (range 55–91 years). Each patient had one tumor treated. One patient had the same tumor treated in two sessions. Tumors included 7 lung cancer primaries, 2 metastatic colon cancers, and 1 metastatic hepatocellular carcinoma. Lesion size ranged from 3.3–34.1 cm2.
Results: All pre-RFA PET scans demonstrated tumor avidity. Patients had CT and FDG-PET scans an average of 44.5 days prior to RFA (range 2–139 days). Following RFA, patients had PET scans an average of 76.5 days later (range 27–173 days). In 7 out of 11 RFA treatments, follow up PET demonstrated persistent rim activity suggestive of a "shell" of residual neoplasm with a central area of photopenia related to the RFA or post ablation recruitment of vessels as an inflammatory response to the injury. Two patients showed no activity on the follow up PET, suggesting complete destruction of any metabolically active neoplasm. One patient had no definite interval change in the appearance or FDG-avidity of the mass when compared to the pre-procedure study. One patient on follow up PET had a smaller size lesion with the same activity, but without a photopenic center. Complications included procedure related pneumothorax in 4 patients.
Conclusion: FDG-PET can be used to assess the amount of tumor destruction after radiofrequency ablation for the treatment of lung tumors and may provide more valuable information than CT alone.
073. Predictors of a Falsely Negative Result in Percutaneous Image-guided Abdominal Biopsies
Sheth S.*; Ali S.; Hamper U.M.; Eng J.; Radiology, Johns Hopkins Medical Institutions, Baltimore, MD.
Address correspondence to S. Sheth (ssheth{at}jhmi.edu)
Objective: Percutaneous image guided biopsies are widely utilized to confirm the diagnosis of malignancy in a radiologically suspicious mass and have largely replaced surgical exploration. In some cases however, cytopathology results do not yield malignant cells. In this instance, it is critical to ensure that the target was truly benign and avoid false negative biopsies that would deny the patient appropriate treatment. Purpose In abdominal biopsies results initially negative for cancer, analyze which factors may influence results, predict a falsely negative result and propose recommendations for further investigations or second biopsy.
Materials and Methods: Material and methods In this retrospective review of 323 consecutive biopsies in which cytology results did not document cancer, the following factors were analyzed: history of or risk factor for cancer, target organ, size of lesion, guidance modality and cytology result. Cytology results were divided in the following 4 categories: non diagnostic, benign specific diagnosis, benign target organ, atypical cells. Follow up was obtained with repeat biopsy, surgery, imaging or clinical follow up for a minimum of 12 months. The following factors will be analyzed: Clinical history: History of cancer Risk factors for cancer: HIV/immunocompromised patient. hepatitis, cirrhosis (this has to be organ specific for the liver) Target organ; Size of lesion: < 1.5 cm 1.5 to 5.9 cm > 5.9 cm (higher chance of necrosis) Cytopathology result on initial biopsy: Non diagnostic Benign specific diagnosis (focal nodular hyperplasia, hemangioma...) that would explain the radiological findings Benign target organ (benign liver, pancreas....) Atypical cells.
Results: The strongest predictor of a false negative diagnosis for the absence of malignancy in a biopsy result was the presence of atypical cells on the initial cytology result.
Conclusion: The presence of atypical cells in an otherwise inconclusive abdominal biopsy warrants additional investigations.
074. Plugged Versus Non-Plugged Percutaneous Biopsies in Children
Raikhlin A.*; Amaral J.G.; Chait P.G.; Connolly B.; Temple M.; John P.; Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.
Address correspondence to A. Raikhlin (antony.raikhlin{at}utoronto.ca)
Objective: To identify differences in post procedural bleeding complications between image-guided plugged (P) and non-plugged (NP) percutaneous biopsies of various organs in children.
Materials and Methods: This is a retrospective observational review. Medical charts of 217 children who had image-guided plugged (n = 78) and non-plugged (n = 139) percutaneous biopsies of various organs (liver, n = 144 [P = 52, NP = 92]; renal, n = 20 [P = 5, NP = 15]; mediastinum, n = 16 [P = 5, NP = 6]; adrenal, n = 15 [P = 7, NP = 8]; spleen, n = 15 [P = 7, NP = 8]; pelvic, n = 4 [P = 1, NP = 3]; soft tissue, n = 3 [P = 1, NP = 2]) performed between May, 2000 and July, 2005 were reviewed. Main outcome measures included: 1) incidence and severity of post-biopsy bleeding as detected by imaging or clinical criteria; 2) changes in serum hemoglobin level as measured pre- and 2–24 hours post-biopsy. The data analysis included an independent-measures t-test and a chi-squared test.
Results: Gelfoam was used in all plugged biopsies. Patients in both groups were similar in age (P = 7.1, NP = 8.4 years; p > 0.05). Patients who underwent plugged biopsies had significantly more passes made than those who underwent regular biopsies (6.77 versus 3.86; p < 0.01). There were 7 (8.8%) bleeding complications in the pluggedbiopsy group, compared with 23 (16.5%) in the non-plugged group. Using the SCVIRclassification for complications, 2 (2.6%) of these complications were major (classes C and D) in the plugged group, compared with 9 (6.5%) in the non-plugged group. These differences were not significant. However, for patients who underwent plugged-biopsies, there was a significantly smaller post-procedural drop in serum hemoglobin compared to the non-plugged group (4.06 versus 10.66 g/L; p < 0.05). The one serious complication (class D) in the plugged-group was due to a ruptured splenic aneurysm that developed several days after a spleen biopsy. The patient was successfully treated with embolization of the bleeding vessels. In the non-plugged group, there were 3 serious (class D) complications that were caused by hemorrhage several hours after the biopsy (1 adrenal, and 2 liver). All 3 patients required repeat transfusions and ICU care.
Conclusion: Image-guided plugged-percutaneous biopsies in children are associated with a reduced drop in hemoglobin level. There is also a tendency for fewer bleeding complications in this group of patients, even though more passes were made in comparison to the non-plugged biopsy patients.
075. Low Radiation Dose for CT-guided Percutaneous Intervention: Feasibility and Results
Lucey B.C.*; Varghese J.C.; Hochberg A.; McGinnis P.; Soto J.A.; Department of Radiology, Division of Body Imaging, Boston University Medical Center, Boston, MA.
Address correspondence to B.C. Lucey (brian.lucey{at}bmc.org)
Objective: The purpose of this study is to evaluate the feasibility of performing CT guided interventional procedures using very low mAs.
Materials and Methods: We performed 291 CT guided interventional procedures over an eighteen month period using low radiation dose technique: males n = 165, females n = 126, age range 22–89 years, mean age 65 years. Procedures performed included percutaneous biopsy n = 201 and percutaneous catheter placement n = 90 in 81 patients. The preliminary images obtained prior to the procedure were obtained using standard mAs determined by the each patient's body habitus and ranged from 175 to 250 mAs. All subsequent CT imaging of needle and catheter placement and post procedural imaging was obtained using 30 mAs, a figure that was chosen as this is the lowest available mAs on our CT scanners. Technical success for catheter placement was defined as successful placement of the catheter into the collection to be drained. Success was not based on successful resolution of the collection. Success for biopsy was determined by obtaining a true positive or true negative result defined either as a positive diagnosis by pathology or a negative pathology result with clinical and imaging follow up. Comparison was made with biopsy results obtained in cases performed over the prior twelve months using standard radiation doses.
Results: All but three catheters were placed successfully into the collections drained using 30 mAs yielding a success rate of 96.7%. In two patients a catheter was placed successfully using 65 mAs and in the third patient, the small collection in the iliacus muscle was aspirated using a needle only using 200 mAs. The technical success rate for biopsies performed using 30 mAs was 93.5%. In 12 patients undergoing biopsy, low dose technique was unable to successfully identify the masses and these procedures were completed using a higher radiation dose. The technical success rates for biopsies performed using standard radiation dose in the twelve months prior to introducing low dose radiation technique was 87.5%. The complication rate using low dose technique was comparable to the standard dose technique.
Conclusion: Low dose radiation technique using 30 mAs results in technical success for both catheter placement and percutaneous biopsy comparable to standard radiation dose.
076. Ultrasound-guided Large Volume Paracentesis in the Management of Refractory Ascites in an Outpatient Setting
Suri R.1*; Chintapalli K.; El-Merhi F.; Dalrymple N.; Prasad S.R.; Freckleton M.; Radiology, University of Texas Health Sciences Center, San Antonio, TX.
Address correspondence to R. Suri (suri{at}uthscsa.edu)
Objective: Refractory ascites cannot be mobilized or satisfactorily prevented by appropriate medical therapy. Paracentesis has been documented to be more effective than medical therapy for its management. Large volume paracentesis (LVP) may have the controversial risk of inducing postparacentesis hypovolemia and consequent hyponatremia leading to renal impairment and requiring admission. The role of concomitant intravenous albumin for volume expansion is also controversial. The purpose of this study was to determine the role of large volume therapeutic paracentesis without volume expansion, in the management of refractory ascites in an outpatient setting.
Materials and Methods: Retrospective review of the interventional database for large volume Paracentesis performed in patients with refractory ascites from June 2001 to February 2005. Thirty seven procedures were done in patients of ages 18–73 yrs. Indications, diagnosis, sample size, complications were tabulated. Peritoneal carcinomatosis was the etiology of ascites in 45% of procedures and cirrhosis in 55%. None of these patients received intravenous volume expanders (IV albumin) during or after the procedure. We excluded procedures where less than 500 cc of ascitic fluid were removed or procedures that were performed in inpatients. Nursing records were evaluated for postprocedural complications. The pre- and post-procedural laboratory data of serum creatinine, sodium and albumin were documented when available. Clinical and imaging follow up was evaluated to assess for delayed complications.
Results: 2.95 +/- 1.4 L of ascitic fluid was drained in the 37 procedures. Repeated LVP were performed in 4 patients. There was no documented intraprocedural or immediate postprocedural complication. None of the patients required admission to the hospital for any procedure related events. There was no documented episode of hypovolemia or postprocedural worsening of hyponatremia or renal impairment. The pre- and post procedural serum sodium and creatinine levels were available in 12 procedures and no significant change was observed.
Conclusion: Large volume paracentesis is safe even without intravenous volume expansion and can be done in the management of refractory ascites.
077. Percutaneous Biopsy of Focal Renal Masses: Safety and Diagnostic Yield in 407 Cases
Samir A.E.*; Hunter S.; Maher M.; Gervais D.; Hahn P.F.; Mueller P.R.; Radiology, Massachusetts General Hospital, Boston, MA.
Address correspondence to A.E. Samir (arrs{at}anthonysamir.sent.com)
Objective: To evaluate the technical performance, safety and histologic yield of percutaneous image guided biopsy of focal renal lesions.
Materials and Methods: An institutional electronic database of interventional radiology procedures was searched to identify percutaneous renal biopsies performed over a seven-year period (Sept 1997–February 2005). 407 image-guided focal renal lesion biopsies were identified. A retrospective review of electronic hospital records including interventional radiology reports, pathology reports, outpatient notes and discharge summaries was performed. The data gathered included (1) imaging modality (2) biopsy technique (3) histopathology results and (4) cytology results.
Results: 407 image-guided focal renal lesion biopsies were performed in 377 patients (M:F 220:157, mean age 65 years). Focal renal biopsies were performed under CT guidance (348 cases, 86%), ultrasound guidance (55 cases, 13%) and CT and ultrasound combined (4 cases, 1%). Core biopsy needles used were 15–18 gauge cutting needles (Temno, Cardinal Health Systems) while 20–23 gauge Chiba needles (Cook, Bloomington, IN) were used for the FNA's. Combined core and fine needle aspiration biopsies were obtained using a 17 gauge co-axial needle system. In 369 cases, combined fine needle aspiration (FNA) and core biopsy (CB) were performed, while in 30 cases CB alone was performed. FNA alone was performed in the remaining 8 cases. Biopsy yielded malignant tissue in 239 of 407 cases (59%), tissue suspicious for malignancy in 44 of 407 cases (11%), oncocytoma in 21 of 407 cases (5%), angiomyolipoma in 15 of 407 cases (4%), metanephric adenoma in 3 of 407 cases (0.7%) and a benign smooth muscle tumor in 1 case (0.2%). Complications were recorded following 13 of 407 biopsies (2%) including 9 cases (2%) requiring overnight hospital admission. Complications included large perinephric hematoma (5), collecting system hemorrhage (2), cerebrovascular accident (1), sepsis (1), gallbladder injury (1), pneumothorax (1), hydronephrosis (2) and prolonged sedation requiring admission for observation (1).
Conclusion: Image-guided percutaneous renal biopsy has a low rate of complications and has a high yield of definitive histopathologic diagnosis.
* Will present paper
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