The highest categories of PADUA and R.E.N.A.L. scores as well as clinical tumor size predict the risk of perioperative complications of partial nephrectomy. Both scores can indicate ischemia time. Their reproducibility is substantial but the implementation of these systems in clinical practice needs further refinement.

E 4 1 5What ' s known on the subject? and What does the study add? Optical Coherence Tomography (OCT) was developed in the early 1990s for ophthalmological application and is currently widely accepted in ophthalmology for retinal imaging purposes. In kidneys, the fi rst experiments were performed on transplant kidneys to investigate the ability of OCT to assess ischaemic damage of kidneys. An ex vivo pilot study on the ability of OCT to differentiate normal renal tissue from malignant renal tissue, showed positive results and here we present the results of the fi rst in vivo experiment.

There is a significant difference in μ(t) between normal and RCC tissue across all patients. These results overpower the lack of significant difference within individuals, encouraging further research and suggesting a possible role for OCT in the diagnostic work-up of renal masses.

RMB is not yet applied widely in urologic practice, with academic urologists performing RMB less infrequently. Core biopsies are still preferred, although combined with cytologic punctures by a considerable number of responders.

PurposeNon-diagnostic results still hinder the routine use of core biopsy (CB) and fine needle aspiration (FNA) in the diagnostic process of renal tumours. Furthermore, substantial interobserver variability has been reported. We assessed the added value of combining the results of CB and FNA by five pathologists in the ex vivo diagnosis of renal mass.MethodsTwo ex vivo core biopsies were taken followed by two FNA passes from extirpated tumours. All samples were evaluated by five blinded pathologists. A consensus diagnosis of the surgical specimen was the index for comparison. For each pathologist, the number of non-diagnostic (non-conclusive or undetermined biology and failed biopsies), correct and incorrect scored cases of each technique was assessed. When a non-diagnostic CB or FNA had a correct diagnostic counterpart, this was considered as of added value.ResultsOf the 57 assessed tumours, 53 were malignant. CB was non-diagnostic in 4–10 cases (7–17.5%). FNA established the correct diagnosis in 1–7 of these cases.FNA was non-diagnostic in 2–6 cases (3.5–10.5%), and the counterpart CB established the correct diagnosis in 1–6 of these cases.For the 5 pathologists, accuracy of CB and FNA varied between 82.5–93% and 89.5–96.5%, respectively. Combination of both types of biopsy resulted in 55–57 correct results (accuracy 96.5–100%), i.e., an increase in accuracy of 3.5–14%.ConclusionCombining the result of CB and FNA in renal mass biopsy leads to a higher diagnostic accuracy. Recommendations on which technique used should be adapted to local expertise and logistic possibilities.