Advertisement

Abdominal Radiology

, Volume 44, Issue 1, pp 333–336 | Cite as

Percutaneous ureteral biopsy: safety and diagnostic yield

  • Andrew C. HendricksonEmail author
  • John J. Schmitz
  • Anil N. Kurup
  • Patrick W. Eiken
  • Theodora A. Potretzke
  • Boyd R. Viers
  • Brendan P. McMenomy
  • Annie T. Packard
  • Michael R. Moynagh
  • Brian T. Welch
Article
  • 51 Downloads

Abstract

Purpose

To evaluate safety and diagnostic yield of percutaneous CT-guided biopsy of extrarenal upper urinary tract lesions.

Materials and methods

Retrospective review of our institutional database of image-guided biopsies yielded 44 CT-guided percutaneous biopsies in 44 unique patients that targeted ureteral (30, 68%) or other non-renal upper urinary tract lesions (14, 32%) between January 1, 2000 and May 1, 2017. Indications, pre-biopsy imaging, biopsy technique, peri-procedural antithrombotic use, complications including bleeding defined by Society of Interventional Radiology criteria, pathology results, and subsequent imaging were reviewed up to 3 months after the procedure to evaluate safety and diagnostic yield.

Results

Mean patient age was 66 (range 27–88) and 23/44 patients were male. The majority (34/44) of lesions were sampled with an 18-gauge biopsy device via a 17-gauge introducer needle, and the remaining 10/44 lesions were sampled with a 19/20 gauge system. The mean number of core samples obtained was 4 (range 2–10). No major complications occurred. Specifically, no patient developed a urine leak or urinary obstruction. Minor complications occurred in 3/44 (7%) biopsies, all retroperitoneal hemorrhages that did not require transfusion or other intervention. Biopsy was adequate for pathologic examination in 41 of 44 (93%) cases. Among patients undergoing surgical resection, biopsy diagnosis was concordant with surgical pathology in 9/10 (90%) cases and discordant in 1/10 (10%).

Conclusion

CT-guided percutaneous biopsy of upper urinary tract lesions can be performed safely, with high diagnostic yield, and with a high rate of concordance on subsequent surgical pathology.

Keywords

Ureter Biopsy Ureteral Percutaneous Safety Concordance 

Notes

Acknowledgments

The authors acknowledge the assistance of Sonia Watson, Ph.D., in preparation of the manuscript.

Compliance with ethical standards

Funding

None.

Conflicts of interest

The authors have no conflicts of interest to declare.

Ethical approval

Institutional Review Board approval was obtained for this retrospective review.

Informed consent

For this type of study formal consent is not required.

References

  1. 1.
    Vashistha V, Shabsigh A, Zynger DL (2013) Utility and diagnostic accuracy of ureteroscopic biopsy in upper tract urothelial carcinoma. Arch Pathol Lab Med 137:400–407.  https://doi.org/10.5858/arpa.2012-0136-OA CrossRefGoogle Scholar
  2. 2.
    Huang SY, Ahrar K, Gupta S, et al. (2015) Safety and diagnostic accuracy of percutaneous biopsy in upper tract urothelial carcinoma. BJU Int 115:625–632.  https://doi.org/10.1111/bju.12824 CrossRefGoogle Scholar
  3. 3.
    Jovanovic M, Soldatovic I, Janjic A, et al. (2011) Diagnostic value of the nuclear matrix protein 22 test and urine cytology in upper tract urothelial tumors. Urol Int 87:134–137.  https://doi.org/10.1159/000330246 CrossRefGoogle Scholar
  4. 4.
    Messer J, Shariat SF, Brien JC, et al. (2011) Urinary cytology has a poor performance for predicting invasive or high-grade upper-tract urothelial carcinoma. BJU Int 108:701–705.  https://doi.org/10.1111/j.1464-410X.2010.09899.x Google Scholar
  5. 5.
    Wang JK, Tollefson MK, Krambeck AE, Trost LW, Thompson RH (2012) High rate of pathologic upgrading at nephroureterectomy for upper tract urothelial carcinoma. Urology 79:615–619.  https://doi.org/10.1016/j.urology.2011.11.049 CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of RadiologyMayo ClinicRochesterUSA
  2. 2.Department of UrologyMayo ClinicRochesterUSA

Personalised recommendations