Accuracy of Percutaneous Core Biopsy in the Diagnosis of Small Renal Masses (≤4.0 cm): A Meta-analysis

Abstract

Objective To use meta-analysis to determine the accuracy of percutaneous core needle biopsy in the diagnosis of small renal masses (SMRs≤4.0 cm).Materials and Methods Studies were identified by searching PubMed, Embase, and the Cochrane Library database up to March 2013. Two of the authors independently assessed the study quality using QUADAS-2 tool and extracted data that met the inclusion criteria. The sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR) and also summary receiver operating characteristic (SROC) curve were investigated and draw. Deek’s funnel plot was used to evaluate the publication bias.Result A total of 9 studies with 788 patients (803 biopsies) were included. Failed biopsies without repeated or aborted from follow-up/surgery result were excluded (232 patients and 353 biopsies). For all cases, the pooled sensitivity was 94.0% (95% CI: 91.0%, 95.0%), the pooled positive likelihood was 22.57 (95% CI: 9.20-55.34), the pooled negative likelihood was 0.09 (95% CI: 0.06-0.13), the pooled DOR was 296.52(95% CI: 99. 42-884.38). The area under the curve of SROC analysis was 0.959±0.0254.Conclusion Imaging-guided percutaneous core needle biopsy of small renal masses (SMRs≤4.0 cm) is highly accurate to malignant tumor diagnosis with unknown metastatic status and could be offered to some patients after clinic judgment prior to surgical intervention consideration.

Diagnostic performance of prospectively assigned clear cell Likelihood scores (ccLS) in small renal masses at multiparametric magnetic resonance imaging

“…He et al report a sensitivity of 95% and a specificity of 100% for detecting malignancy, however this analysis excluded nondiagnostic biopsies. Also, evaluation of specificity (true-negative) is obfuscated by the fact that negative biopsies did not lead to extirpative surgery and therefore had no confirming pathology [22]. Moreover, diagnostic performance of RMB is commonly inflated because patients in whom a biopsy is considered unsafe are not included in the final cohort.…”

Small renal masses in the era of personalized medicine: Tumor heterogeneity, growth kinetics, and risk of metastasis

“…A recent metaanalysis has confirmed the accuracy of biopsies in selected patients with SRMs [61]. Prospective studies could provide data on the long-term behavior of SRMs, paving the way to a routine employment of renal biopsies with a subsequent decreased number of nephrectomies.…”

Masas renales pequeñas: predictores de malignidad en una serie de 10 años

“…Existe cierta renuencia entre los urólogos a solicitar la BRP, probablemente por el bajo rendimiento y la considerable tasa de complicaciones iniciales que fueron reportadas en la literatura. Sin embargo, según las series recientes, 84-90% de las BRP en las MRP son diagnósticas, al compararlas con las biopsias definitivas, con una sensibilidad de 94% y especificidad cercana 100% [25][26][27] y solo 14% de biopsias no diagnósticas 28 . Simultáneamente, la evidencia actual muestra que la BRP constituye un procedimiento seguro, con una tasa de complicaciones menor a 9% y siendo estas de bajo impacto clínico en la mayoría de los casos 26,27,29-31 con tasas de hematoma de 5%, dolor 1%, hematuria 1%, y de requerimiento de transfusión 0,4% 28 .…”