Evolving role of renal biopsy in small renal masses

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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The Role of Percutaneous Renal Biopsy in the Management of Small Renal Masses

Current Urology Reports ◽

10.1007/s11934-010-0149-x ◽

2010 ◽

Vol 12 (1) ◽

pp. 18-23 ◽

Cited By ~ 14

Author(s):

Rou Wang ◽

Amy Y. Li ◽

David P. Wood

Keyword(s):

Renal Biopsy ◽

Small Renal Masses ◽

Renal Masses ◽

Percutaneous Renal Biopsy

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312 The role of image-guided renal biopsy in managing small renal masses (SMR) across the SWSH cancer network

European Urology Supplements ◽

10.1016/s1569-9056(14)60307-9 ◽

2014 ◽

Vol 13 (1) ◽

pp. e312

Author(s):

R. Zakri ◽

A. Emara ◽

M. Hussain ◽

N. Barber

Keyword(s):

Renal Biopsy ◽

Small Renal Masses ◽

Renal Masses ◽

Image Guided ◽

Cancer Network

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The role of laparoscopy and robotic surgery in the management of small renal masses

Expert Review of Anticancer Therapy ◽

10.1586/era.12.55 ◽

2012 ◽

Vol 12 (6) ◽

pp. 799-810

Author(s):

David Hrouda ◽

Andrew Lienert

Keyword(s):

Robotic Surgery ◽

Small Renal Masses ◽

Renal Masses

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The role of renal mass biopsy in the management of small renal masses – patterns of use and surgeon opinion

Journal of Clinical Urology ◽

10.1177/2051415819894181 ◽

2020 ◽

Vol 13 (5) ◽

pp. 356-363

Author(s):

Melinda M Protani ◽

Andre Joshi ◽

Victoria White ◽

David JT Marco ◽

Rachel E Neale ◽

...

Keyword(s):

Medical Records ◽

Renal Mass ◽

Practice Variation ◽

Small Renal Masses ◽

Level Of Evidence ◽

Renal Masses ◽

Patterns Of Use ◽

Renal Mass Biopsy ◽

Pre Treatment

Aims: Renal mass biopsy (RMB) is advocated to improve management of small renal masses, however there is concern about its clinical utility. This study aimed to elicit opinions about the role of RMB in small renal mass management from surgeons managing renal cell carcinomas (RCC), and examine the frequency of pre-treatment biopsy in those with RCC. Methods: All surgeons in two Australian states (Queensland: n = 59 and Victoria: n = 108) who performed nephrectomies for RCC in 2012/2013 were sent questionnaires to ascertain views about RMB. Response rates were 54% for Queensland surgeons and 38% for Victorian surgeons. We used medical records data from RCC patients to determine RMB frequency. Results: Most Queensland (81%) and Victorian (59%) surgeons indicated they rarely requested RMB; however 34% of Victorians reported often requesting RMB, compared with no Queensland surgeons. This was consistent with medical records data: 17.6% of Victorian patients with T1a tumours received RMB versus 6.7% of Queensland patients ( p < 0.001). Surgeons’ principal concerns regarding RMB related to sampling reliability (90%) and/or histopathological interpretation (76%). Conclusions: Most surgeons report infrequent use of RMB for small renal masses, however we observed practice variation. The principal reasons for infrequent use were concerns about sampling reliability and histopathological interpretation, which may be valid in regions with less access to interventional radiologists and uropathologists. Further evidence is required to define patient groups for whom biopsy results will alter management. Level of evidence: Not applicable for this multicentre audit.

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