Percutaneous image-guided core biopsy of solid renal masses: analysis of safety, efficacy, pathologic interpretation, and clinical significance.
Purpose: To determine the efficacy, safety and clinical utility of CT and US-guided percutaneous renal mass biopsy.Materials and methods: A retrospective IRB-approved, HIPAA-compliant study of a cohort of 183 consecutive patients who underwent percutaneous, CT or US—guided renal mass biopsy (RMB) fr...
| Publicado en: | Abdominal Radiology Vol. 43; no. 7; pp. 1813 - 1820 |
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| Autores principales: | , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Jul2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130627382&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 130627382 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 2366004X JT14 jtl: Abdominal Radiology issn: 2366004X maglogo: N pubinfo: dt: Jul2018 vid: 43 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 130627382 10.1007/s00261-017-1337-7 130627382 ppf: 1813 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Percutaneous image-guided core biopsy of solid renal masses: analysis of safety, efficacy, pathologic interpretation, and clinical significance. aug: au: Tan, Nelly Alle, Nisha Raman, Steven S. Huss, Julie Huang, Jiatoi Pantuck, Allan affil: The Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA sug: ab: Purpose: To determine the efficacy, safety and clinical utility of CT and US-guided percutaneous renal mass biopsy.Materials and methods: A retrospective IRB-approved, HIPAA-compliant study of a cohort of 183 consecutive patients who underwent percutaneous, CT or US—guided renal mass biopsy (RMB) from March 2002 through December 2012 was performed. RMB was performed in 183 consecutive patients for suspected solid renal mass of whom 14/183 (7.7%) were excluded because biopsies were performed at an outside institution, medical records were incomplete, or lesions were poorly visualized. Ten patients had multiple biopsies for new growing masses. Using US, CT or CT/US fusion-guidance, a 17G or 19G cannula needle was placed at the margin of the mass and an 18G or 20G core biopsy gun was used to obtain several tissue cores. Renal parenchymal biopsies for medical renal diseases were excluded. Imaging variables (including size, location, and extent of disease), number of core biopsies, patient demographics (age, gender), clinical indication, final pathologic diagnosis, immunohistochemical (IHC) studies, and subsequent final pathological diagnosis on nephrectomy were evaluated.Results: Of the 169 patients with 184 RMB, 121/169 (71.6%) were male with a mean age of 67.5 years. Of 184 RMB, 126 were malignant [126/184 (68.5%)], 37 [37/184 (20.1%)], were benign, and 21 (21/184 (11.4%) were nondiagnostic. IHC was performed in 131 biopsies (71.1%) and was diagnostic in 88.5% of those cases. Twenty-eight patients underwent subsequent partial nephrectomy; in 27/27 (100%) cases, RMB was concordant with nephrectomy for malignancy and in 21/27 (77.8%) RMB was concordant for subtype of RCC. Overall, the RMB sensitivity for detection of malignancy, specificity, and positive predictive value were 100%. The negative predictive value of benign RMB diagnosis was also 100%. There was a total of 14 (7.6%) complications, 13 minor (7.1%) and 1 major (0.5%). Of the minor complications, ten (5.5%) were postprocedural minor hematomas that resolved conservatively; one (0.5%) postprocedural vasovagal reaction; one (0.5%) episode of hematuria; and one (0.5%) episode of nausea and abdominal discomfort. No cases of renal pseudoaneurysm or tumor seeding attributed to biopsy were identified.Conclusion: Percutaneous image-guided RMB is safe and highly diagnostic when combined with IHC and supports a greater role of RMB and imaging in evaluating renal masses when rendering appropriate treatments. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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