Skip to main content
Erschienen in: European Radiology 2/2011

01.02.2011 | Interventional

Diagnostic accuracy and clinical impact of imaging-guided needle biopsy of renal masses. Retrospective analysis on 150 cases

verfasst von: Andrea Veltri, Irene Garetto, Irene Tosetti, Marco Busso, Alessandro Volpe, Donatella Pacchioni, Enrico Bollito, Mauro Papotti

Erschienen in: European Radiology | Ausgabe 2/2011

Einloggen, um Zugang zu erhalten

Abstract

Objective

To review our method of perform needle biopsies of renal masses.

Methods

We analysed 150 consecutive imaging-guided percutaneous biopsies. The pathological diagnosis was verified on clinical outcome in 129 cases (40 surgical resection, 53 thermal ablation, two medical treatment and 34 watchful waiting). Twenty-six patients underwent fine-needle aspiration biopsy (FNAB), 45 core-needle biopsy (CB) and 58 FNAB + CB. After review by two expert pathologists, cumulative accuracy of all FNAB (84) and all CB (103) was calculated. The rate of complications and mass management other than surgery was estimated.

Results

The final diagnosis was malignancy in 97 cases (benign mass in 32). FNAB correctly diagnosed 64/84 masses (76.2%), CB 96/103 (93.2%). Of 58 masses submitted for both FNAB and CB, CB provided a 22.5% accuracy improvement. Major and minor complications occurred in 0% and 5.3%. Renal biopsy altered clinical management in 89/129 cases (68.9%), in terms of choosing therapeutic options other than surgery.

Conclusion

CB is more accurate than FNAB and should be preferred in renal mass biopsy. FNAB may precede CB when an expert pathologist can immediately evaluate the samples. Renal biopsy influences renal mass management.
Literatur
1.
Zurück zum Zitat Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ (2007) Cancer statistics, 2007. CA Cancer J Clin 57:43CrossRefPubMed Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ (2007) Cancer statistics, 2007. CA Cancer J Clin 57:43CrossRefPubMed
2.
Zurück zum Zitat Lotan Y, Cadeddu J (2005) A cost comparison of nephron-sparing surgical techniques for renal tumour. BJU Int 95:1039–1042CrossRefPubMed Lotan Y, Cadeddu J (2005) A cost comparison of nephron-sparing surgical techniques for renal tumour. BJU Int 95:1039–1042CrossRefPubMed
3.
Zurück zum Zitat Veltri A, Grosso M, Castagneri F, Garetto I, Sacchetto P, Tosetti I, Stratta P, Terrone C, Fava C (2009) Radiofrequency thermal ablation of small tumors in transplanted kidneys: an evolving nephron-sparing option. J Vasc Interv Radiol 20:674–679CrossRefPubMed Veltri A, Grosso M, Castagneri F, Garetto I, Sacchetto P, Tosetti I, Stratta P, Terrone C, Fava C (2009) Radiofrequency thermal ablation of small tumors in transplanted kidneys: an evolving nephron-sparing option. J Vasc Interv Radiol 20:674–679CrossRefPubMed
4.
Zurück zum Zitat Feldman AS, Gervais D, Cutie CJ, Mueller PR, McDougal SW (2006) A comparison of nephron-sparing techniques: percutaneous radiofrequency ablation (RFA) vs. open and laparoscopic partial nephrectomy. AUA ABST 1114 Feldman AS, Gervais D, Cutie CJ, Mueller PR, McDougal SW (2006) A comparison of nephron-sparing techniques: percutaneous radiofrequency ablation (RFA) vs. open and laparoscopic partial nephrectomy. AUA ABST 1114
5.
Zurück zum Zitat Stern JM, Svatek R, Park S, Hermann M, Lotan Y, Sagalowsky AI, Cadeddu JA (2007) Intermediate comparison of partial nephrectomy and radiofrequency ablation for clinical T1a renal tumours. BJU Int 100:287–290CrossRefPubMed Stern JM, Svatek R, Park S, Hermann M, Lotan Y, Sagalowsky AI, Cadeddu JA (2007) Intermediate comparison of partial nephrectomy and radiofrequency ablation for clinical T1a renal tumours. BJU Int 100:287–290CrossRefPubMed
6.
Zurück zum Zitat Kunkle DA, Egleston BL, Uzzo RG (2008) Excise, ablate or observe: the small renal mass dilemma. A meta-analysis and review. J Urol 179:1227–1234CrossRefPubMed Kunkle DA, Egleston BL, Uzzo RG (2008) Excise, ablate or observe: the small renal mass dilemma. A meta-analysis and review. J Urol 179:1227–1234CrossRefPubMed
7.
Zurück zum Zitat Chawla SN, Crispen PL, Hanlon AL, Greenberg RE, Chen DY, Uzzo RG (2006) The natural history of observed enhancing renal masses: meta-analysis and review of the world literature. J Urol 175:425CrossRefPubMed Chawla SN, Crispen PL, Hanlon AL, Greenberg RE, Chen DY, Uzzo RG (2006) The natural history of observed enhancing renal masses: meta-analysis and review of the world literature. J Urol 175:425CrossRefPubMed
8.
Zurück zum Zitat Campbell SC, Novick AC, Herts B, Fischler DF, Meyer J, Levin HS et al (1997) Prospective evaluation of fine needle aspiration of small, solid renal masses: accuracy and morbidity. Urology 50:25CrossRefPubMed Campbell SC, Novick AC, Herts B, Fischler DF, Meyer J, Levin HS et al (1997) Prospective evaluation of fine needle aspiration of small, solid renal masses: accuracy and morbidity. Urology 50:25CrossRefPubMed
9.
Zurück zum Zitat Clark TW, Millward SF, Gervais DA, Goldberg SN, Grassi CJ, Kinney TB, Philips DA, Sacks D, Cardella JF (2006) Reporting standards for percutaneous thermal ablation of renal cell carcinoma. J Vasc Interv Radiol 17:1563–1570CrossRefPubMed Clark TW, Millward SF, Gervais DA, Goldberg SN, Grassi CJ, Kinney TB, Philips DA, Sacks D, Cardella JF (2006) Reporting standards for percutaneous thermal ablation of renal cell carcinoma. J Vasc Interv Radiol 17:1563–1570CrossRefPubMed
10.
Zurück zum Zitat Volpe A, Mattar K, Finelli A, Kachura JR, Evans AJ, Geddie WR, Jewett MAS (2008) Contemporary results of percutaneous biopsy of 100 small renal masses: a single center experience. J Urol 180:2333–2337CrossRefPubMed Volpe A, Mattar K, Finelli A, Kachura JR, Evans AJ, Geddie WR, Jewett MAS (2008) Contemporary results of percutaneous biopsy of 100 small renal masses: a single center experience. J Urol 180:2333–2337CrossRefPubMed
11.
Zurück zum Zitat Gervais DA, McGovern FJ, Arellano RS, McDougal WS, Mueller PR (2005) Radiofrequency ablation of renal cell carcinoma. Part 1. Indications, results, and role in patient management over a 6-year period and ablation of 100 tumors. AJR Am J Roentgenol 185:64–71PubMed Gervais DA, McGovern FJ, Arellano RS, McDougal WS, Mueller PR (2005) Radiofrequency ablation of renal cell carcinoma. Part 1. Indications, results, and role in patient management over a 6-year period and ablation of 100 tumors. AJR Am J Roentgenol 185:64–71PubMed
12.
13.
Zurück zum Zitat Motzer RJ, Basch E (2007) Targeted drugs for metastatic renal cell carcinoma. Lancet 22:370(9605):2071–2073 Motzer RJ, Basch E (2007) Targeted drugs for metastatic renal cell carcinoma. Lancet 22:370(9605):2071–2073
14.
Zurück zum Zitat Chowdhury S, Larkin JM, Gore ME (2008) Recent advances in the treatment of renal cell carcinoma and the role of targeted therapies. Eur J Cancer 44:2152–2161CrossRefPubMed Chowdhury S, Larkin JM, Gore ME (2008) Recent advances in the treatment of renal cell carcinoma and the role of targeted therapies. Eur J Cancer 44:2152–2161CrossRefPubMed
15.
Zurück zum Zitat Malloy PC, Grassi CJ, Kundu S, Gervais DA, Miller DL, Osnis RB, Postoak DW, Rajan DK, Sacks D, Schwartzberg MS, Zuckerman DA, Cardella JF (2009) Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 20(7 Suppl):S240–S249CrossRefPubMed Malloy PC, Grassi CJ, Kundu S, Gervais DA, Miller DL, Osnis RB, Postoak DW, Rajan DK, Sacks D, Schwartzberg MS, Zuckerman DA, Cardella JF (2009) Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 20(7 Suppl):S240–S249CrossRefPubMed
16.
Zurück zum Zitat Volpe A, Kachura JR, Geddie WR, Evans AJ, Gharajeh A, Saravanan A, Jewett AS (2007) Techniques, safety and accuracy of sampling of renal tumors by fine needle aspiration and core biopsy. J Urol 178:379–386CrossRefPubMed Volpe A, Kachura JR, Geddie WR, Evans AJ, Gharajeh A, Saravanan A, Jewett AS (2007) Techniques, safety and accuracy of sampling of renal tumors by fine needle aspiration and core biopsy. J Urol 178:379–386CrossRefPubMed
17.
Zurück zum Zitat Eble JN, Sauter J, Epstein JI et al (2004) World health organization classification of tumors. Pathology and genetics of tumors of the urinary system and male genital organs. IARC, Lyon Eble JN, Sauter J, Epstein JI et al (2004) World health organization classification of tumors. Pathology and genetics of tumors of the urinary system and male genital organs. IARC, Lyon
18.
Zurück zum Zitat Fuhrman SA, Lasky LC, Limas C (1982) Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol 6:655–663CrossRefPubMed Fuhrman SA, Lasky LC, Limas C (1982) Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol 6:655–663CrossRefPubMed
19.
Zurück zum Zitat Maturen KE, Nghiem HV, Caoili EM, Higgins EG, Wolf JS, Wood DP (2007) Renal mass core biopsy: accuracy and impact on clinical management. AJR Am J Roentgenol 188:563CrossRefPubMed Maturen KE, Nghiem HV, Caoili EM, Higgins EG, Wolf JS, Wood DP (2007) Renal mass core biopsy: accuracy and impact on clinical management. AJR Am J Roentgenol 188:563CrossRefPubMed
20.
Zurück zum Zitat Neuzillet Y, Lechevallier E, Andre M, Daniel L, Coulange C (2004) Accuracy and clinical role of fine needle percutaneous biopsy with computerized tomography guidance of small (less than 4.0 cm) renal masses. J Urol 171:1802CrossRefPubMed Neuzillet Y, Lechevallier E, Andre M, Daniel L, Coulange C (2004) Accuracy and clinical role of fine needle percutaneous biopsy with computerized tomography guidance of small (less than 4.0 cm) renal masses. J Urol 171:1802CrossRefPubMed
21.
Zurück zum Zitat Appelbaum AH, Kamba TT, Cohen AS (2002) Effectiveness and safety of image-directed biopsies: coaxial technique vs conventional fine-needle aspiration. South Med J 95:212–217PubMed Appelbaum AH, Kamba TT, Cohen AS (2002) Effectiveness and safety of image-directed biopsies: coaxial technique vs conventional fine-needle aspiration. South Med J 95:212–217PubMed
22.
Zurück zum Zitat Brown DB, Gonsalves CF (2008) Percutaneous biopsy before interventional oncologic therapy: current status. J Vasc Interv Radiol 19:973–979CrossRefPubMed Brown DB, Gonsalves CF (2008) Percutaneous biopsy before interventional oncologic therapy: current status. J Vasc Interv Radiol 19:973–979CrossRefPubMed
23.
Zurück zum Zitat Eshed I, Elias S, Sidi AA (2004) Diagnostic value of CT guided biopsy of indeterminate renal masses. Clin Radiol 59:262–267CrossRefPubMed Eshed I, Elias S, Sidi AA (2004) Diagnostic value of CT guided biopsy of indeterminate renal masses. Clin Radiol 59:262–267CrossRefPubMed
24.
Zurück zum Zitat Lechevallier E, Andre M, Barriol D et al (2000) Fine-needle percutaneous biopsy of renal masses with helical CT guidance. Radiology 216:506–510PubMed Lechevallier E, Andre M, Barriol D et al (2000) Fine-needle percutaneous biopsy of renal masses with helical CT guidance. Radiology 216:506–510PubMed
25.
Zurück zum Zitat Caoili EM, Bude RO, Higgins EJ, Hoff DL, Nghiem HV (2002) Evaluation of sonographically guided percutaneous core biopsy of renal masses. AJR Am J Roentgenol 179:373–378PubMed Caoili EM, Bude RO, Higgins EJ, Hoff DL, Nghiem HV (2002) Evaluation of sonographically guided percutaneous core biopsy of renal masses. AJR Am J Roentgenol 179:373–378PubMed
26.
Zurück zum Zitat Heilbrun ME, Zagoria RJ, Garvin AJ, Hall MC, Krehbiel K, Sothwick A, Clark PE (2007) CT-guided biopsy for the diagnosis of renal tumors before treatment with percutaneous ablation. AJR Am J Roentgenol 188:1500–1505CrossRefPubMed Heilbrun ME, Zagoria RJ, Garvin AJ, Hall MC, Krehbiel K, Sothwick A, Clark PE (2007) CT-guided biopsy for the diagnosis of renal tumors before treatment with percutaneous ablation. AJR Am J Roentgenol 188:1500–1505CrossRefPubMed
27.
Zurück zum Zitat Laguna MP, Kummerlin I, Rioja J, De la Rosette J (2009) Biopsy of a renal mass: where are we now? Curr Opin Urol 19:447–453CrossRefPubMed Laguna MP, Kummerlin I, Rioja J, De la Rosette J (2009) Biopsy of a renal mass: where are we now? Curr Opin Urol 19:447–453CrossRefPubMed
28.
Zurück zum Zitat Lau WK, Cheville JC, Blute ML, Weaver AL, Zincke H (2002) Prognostic features of pathologic stage T1 renal cell carcinoma after radical nephrectomy. Urology 59:532–537CrossRefPubMed Lau WK, Cheville JC, Blute ML, Weaver AL, Zincke H (2002) Prognostic features of pathologic stage T1 renal cell carcinoma after radical nephrectomy. Urology 59:532–537CrossRefPubMed
29.
Zurück zum Zitat Lebret T, Poulain JE, Molinie V et al (2007) Percutaneous core biopsy for renal masses: indications, accuracy and results. J Urol 178:1144–1148CrossRef Lebret T, Poulain JE, Molinie V et al (2007) Percutaneous core biopsy for renal masses: indications, accuracy and results. J Urol 178:1144–1148CrossRef
30.
Zurück zum Zitat Beland MD, Mayo-Smith WW, Dupuy DE, Cronan JJ, DeLellis RA (2007) Diagnostic yield of 58 consecutive imaging-guided biopsies of solid renal masses: should we biopsy all that are indeterminate? AJR Am J Roentgenol 188:792–797CrossRefPubMed Beland MD, Mayo-Smith WW, Dupuy DE, Cronan JJ, DeLellis RA (2007) Diagnostic yield of 58 consecutive imaging-guided biopsies of solid renal masses: should we biopsy all that are indeterminate? AJR Am J Roentgenol 188:792–797CrossRefPubMed
31.
Zurück zum Zitat Barocas DA, Rohan SM, Kao J, Gurevich RD, Del Pizzo JJ, Vaughan ED Jr et al (2006) Diagnosis of renal tumors on needle biopsy specimens by histological and molecular analysis. J Urol 176:1957–1962CrossRefPubMed Barocas DA, Rohan SM, Kao J, Gurevich RD, Del Pizzo JJ, Vaughan ED Jr et al (2006) Diagnosis of renal tumors on needle biopsy specimens by histological and molecular analysis. J Urol 176:1957–1962CrossRefPubMed
32.
Zurück zum Zitat Lane BR, Babineau D, Kattan MW, Novick AC, Gill IS, Zhou M et al (2007) A preoperative prognostic nomogram for solid enhancing renal tumors 7 cm or less amenable to partial nephrectomy. J Urol 178:429CrossRefPubMed Lane BR, Babineau D, Kattan MW, Novick AC, Gill IS, Zhou M et al (2007) A preoperative prognostic nomogram for solid enhancing renal tumors 7 cm or less amenable to partial nephrectomy. J Urol 178:429CrossRefPubMed
33.
Zurück zum Zitat Lane BR, Samplaski MK, Herts BR, Zhou M, Novick AC, Campbell SC (2008) Renal mass biopsy—a renaissance? J Urol 179:20–27CrossRefPubMed Lane BR, Samplaski MK, Herts BR, Zhou M, Novick AC, Campbell SC (2008) Renal mass biopsy—a renaissance? J Urol 179:20–27CrossRefPubMed
Metadaten
Titel
Diagnostic accuracy and clinical impact of imaging-guided needle biopsy of renal masses. Retrospective analysis on 150 cases
verfasst von
Andrea Veltri
Irene Garetto
Irene Tosetti
Marco Busso
Alessandro Volpe
Donatella Pacchioni
Enrico Bollito
Mauro Papotti
Publikationsdatum
01.02.2011
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 2/2011
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1938-9

Weitere Artikel der Ausgabe 2/2011

European Radiology 2/2011 Zur Ausgabe

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.