Percutaneous Core Biopsy for Renal Masses: Indications, Accuracy and Results

Lebrét, Thierry; Poulain, Jean Eudes; Molinié, Vincent; Hervé, Jean Marie; Denoux, Yves; Guth, A.; Scherrer, Antoine; Botto, Henry

doi:10.1016/j.juro.2007.05.155

Cited by 189 publications

(118 citation statements)

References 18 publications

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“…The reported accuracy of percutaneous biopsy of renal cortical tumors ranges from 70% to 90% (16)(17)(18)(19)(20), and recent advances in imaging and image-guided intervention, as well as cytologic, immunohistochemical, and molecular techniques, might further expand the role of percutaneous biopsy in the diagnosis of renal cortical tumors (20). However, widespread use of biopsy of renal cortical tumors has been controversial in the urology community owing to factors such as (a) the invasiveness and the potential complications of biopsy, (b) the possibility of sampling errors and the dependence on R enal cortical tumors represent a complex family of neoplasms with unique histopathologic features, cytogenetic defects, and variable clinical behaviors, ranging from the benign oncocytoma to indolent variants of papillary and chromophobe carcinomas to the more aggressive conventional clear cell The first postcontrast sequence was acquired 5 seconds after peak arterial enhancement, followed by 70 seconds after contrast material administration and 3-4 minutes after contrast material administration.…”

Section: Discussionmentioning

confidence: 99%

Renal Cortical Tumors: Use of Multiphasic Contrast-enhanced MR Imaging to Differentiate Benign and Malignant Histologic Subtypes

Vargas

Chaim²,

Lefkowitz³

et al. 2012

Radiology

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Purpose:To investigate the use of quantitative multiphasic contrast material-enhanced magnetic resonance (MR) imaging in differentiating between common benign and malignant histologic subtypes of renal cortical tumors. Materials and Methods:The institutional review board waived informed consent and approved this retrospective HIPAA-compliant study of 138 patients who underwent preoperative contrastenhanced MR imaging during the period of January 2004-December 2008. At surgery, 152 renal tumors were identified (77 clear cell, 22 papillary, 18 chromophobe, and 10 unclassified carcinomas; 16 oncocytomas; nine angiomyolipomas). Three readers independently identified and measured the most-enhanced area in each tumor and placed corresponding regions of interest in similar positions on images from the precontrast, corticomedullary, nephrographic, and excretory phases. The percentage change in signal intensity (%SI change) between precontrast imaging and each postcontrast phase was calculated.Interreader agreement was evaluated by using the overall concordance correlation coefficient (OCC). A linear mixed-effects model was used to estimate and compare the trajectories of the means of log %SI change across all phases between the six histologic subtypes. results:Interreader agreement was substantial to almost perfect (OCC, 0.77-0.88). The %SI change differed significantly between clear cell carcinomas and papillary and chromophobe carcinomas in all phases of enhancement (P , .0001-.0120). In addition, %SI change was significantly higher in angiomyolipomas than in clear cell carcinomas, but only in the corticomedullary phase (P = .0231). Enhancement did not differ significantly between clear cell carcinoma and oncocytoma in any phase (P = .2081-.6000). conclusion:Quantitative multiphase contrast-enhanced MR imaging offers a widely available, reproducible method to characterize several histologic subtypes of renal cortical tumors, although it does not aid differentiation between clear cell carcinomas and oncocytomas.q RSNA, 20121 From the Departments of Radiology (H

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Section: Discussionmentioning

confidence: 99%

Renal Cortical Tumors: Use of Multiphasic Contrast-enhanced MR Imaging to Differentiate Benign and Malignant Histologic Subtypes

Vargas

Chaim²,

Lefkowitz³

et al. 2012

Radiology

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“…Although few cases have been reported in the literature, 5,12 no cases of seeding have been reported when a coaxial technique is used. 2,[13][14][15][16][17][18][19][20][21] Complication rate of the procedure is low, at around 1%. Bleeding represents the most frequent complication, which usually results in a subcapsular or perinephric haematoma requiring no interventional treatment.…”

Section: Renal Biopsy Techniquementioning

confidence: 99%

“…However, in those studies in which Fuhrman grade was divided in a dichotomous manner -low (I and II) and high (III and IV) grade -the accuracy was significantly higher. 15 …”

Section: Diagnostic Performancementioning

confidence: 99%

The role of renal biopsy in small renal masses

Burruni

Lhermitte

Cerantola

et al. 2016

CUAJ

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Renal biopsy is being increasingly proposed as a diagnostic tool to characterize small renal masses (SRM). Indeed, the wide adoption of imaging in the diagnostic workup of many diseases had led to a substantial increased incidence of SRM (diameter ≤4 cm). While modern ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) techniques have high sensitivity for detecting SRM, none is able to accurately and reliably characterize them in terms of histological features. This is currently of key importance in guiding clinical decision-making in some situations, and in these cases renal biopsy should be considered.In this review, we aim to summarize the technique, diagnostic performance, and predicting factors of nondiagnostic biopsy, as well as the future perspectives.

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“…Percutaneous biopsy can provide a histological diagnosis in selected patients, although inaccurate subtyping rates can occur in up to a quarter of primary tumors and the procedure is not without risk [12]. Therefore, a method to characterize tumors and to predict their biological behavior accurately remains somewhat elusive.…”

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confidence: 99%