Advertisement

Renal Mass Biopsy

  • Matthew D. Ingham
  • Adam S. FeldmanEmail author
Chapter

Abstract

In this chapter we address the contemporary issues surrounding the use of percutaneous renal mass biopsy. We review current opinions surrounding the appropriate indications for renal mass biopsy as dictated by both expert opinion and clinical consensus guidelines. We then delve into the technical aspects of percutaneous renal mass biopsy. The diagnostic accuracy and utility of percutaneous renal mass biopsy results are then explored by reviewing a number of large, contemporary series, and meta-analyses. We then review the potential complications associated with percutaneous renal mass biopsy and how to best minimize their occurrence. Lastly, we review the economic implications of percutaneous renal mass biopsy when utilized as part of the diagnosis and management of the small renal mass.

Keywords

Small renal mass Renal mass biopsy Percutaneous biopsy Kidney biopsy Coaxial technique Fine-needle aspirate Tract seeding 

References

  1. 1.
    Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67(1):7–30. Epub 2017/01/06CrossRefGoogle Scholar
  2. 2.
    Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr. Rising incidence of renal cell cancer in the United States. JAMA. 1999;281(17):1628–31. Epub 1999/05/11CrossRefGoogle Scholar
  3. 3.
    Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK. Rising incidence of small renal masses: a need to reassess treatment effect. J Natl Cancer Inst. 2006;98(18):1331–4. Epub 2006/09/21CrossRefGoogle Scholar
  4. 4.
    Levi F, Ferlay J, Galeone C, Lucchini F, Negri E, Boyle P, et al. The changing pattern of kidney cancer incidence and mortality in Europe. BJU Int. 2008;101(8):949–58. Epub 2008/02/05CrossRefGoogle Scholar
  5. 5.
    King SC, Pollack LA, Li J, King JB, Master VA. Continued increase in incidence of renal cell carcinoma, especially in young patients and high grade disease: United States 2001 to 2010. J Urol. 2014;191(6):1665–70. Epub 2014/01/16CrossRefGoogle Scholar
  6. 6.
    O'Connor SD, Pickhardt PJ, Kim DH, Oliva MR, Silverman SG. Incidental finding of renal masses at unenhanced CT: prevalence and analysis of features for guiding management. AJR Am J Roentgenol. 2011;197(1):139–45. Epub 2011/06/28CrossRefGoogle Scholar
  7. 7.
    Volpe A, Panzarella T, Rendon RA, Haider MA, Kondylis FI, Jewett MA. The natural history of incidentally detected small renal masses. Cancer. 2004;100(4):738–45. Epub 2004/02/11CrossRefGoogle Scholar
  8. 8.
    Guethmundsson E, Hellborg H, Lundstam S, Erikson S, Ljungberg B. Metastatic potential in renal cell carcinomas </=7 cm: Swedish kidney cancer quality register data. Eur Urol. 2011;60(5):975–82. Epub 2011/07/12CrossRefGoogle Scholar
  9. 9.
    Gill IS, Aron M, Gervais DA, Jewett MA. Clinical practice. Small renal mass. N Engl J Med. 2010;362(7):624–34. Epub 2010/02/19CrossRefGoogle Scholar
  10. 10.
    Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H. Solid renal tumors: an analysis of pathological features related to tumor size. J Urol. 2003;170(6 Pt 1):2217–20. Epub 2003/11/25CrossRefGoogle Scholar
  11. 11.
    Johnson DC, Vukina J, Smith AB, Meyer AM, Wheeler SB, Kuo TM, et al. Preoperatively misclassified, surgically removed benign renal masses: a systematic review of surgical series and United States population level burden estimate. J Urol. 2015;193(1):30–5. Epub 2014/07/30CrossRefGoogle Scholar
  12. 12.
    Leppert JT, Hanley J, Wagner TH, Chung BI, Srinivas S, Chertow GM, et al. Utilization of renal mass biopsy in patients with renal cell carcinoma. Urology. 2014;83(4):774–9. Epub 2014/02/18CrossRefGoogle Scholar
  13. 13.
    Barwari K, de la Rosette JJ, Laguna MP. The penetration of renal mass biopsy in daily practice: a survey among urologists. J Endourol. 2012;26(6):737–47. Epub 2011/12/29CrossRefGoogle Scholar
  14. 14.
    Silverman SG, Gan YU, Mortele KJ, Tuncali K, Cibas ES. Renal masses in the adult patient: the role of percutaneous biopsy. Radiology. 2006;240(1):6–22. Epub 2006/05/20CrossRefGoogle Scholar
  15. 15.
    Rybicki FJ, Shu KM, Cibas ES, Fielding JR, vanSonnenberg E, Silverman SG. Percutaneous biopsy of renal masses: sensitivity and negative predictive value stratified by clinical setting and size of masses. AJR Am J Roentgenol. 2003;180(5):1281–7. Epub 2003/04/22CrossRefGoogle Scholar
  16. 16.
    Rosenfield AT, Glickman MG, Taylor KJ, Crade M, Hodson J. Acute focal bacterial nephritis (acute lobar nephronia). Radiology. 1979;132(3):553–61. Epub 1979/09/01CrossRefGoogle Scholar
  17. 17.
    Pierorazio PM, Johnson MH, Ball MW, Gorin MA, Trock BJ, Chang P, et al. Five-year analysis of a multi-institutional prospective clinical trial of delayed intervention and surveillance for small renal masses: the DISSRM registry. Eur Urol. 2015;68(3):408–15. Epub 2015/02/24CrossRefGoogle Scholar
  18. 18.
    Capitanio U, Volpe A. Renal tumor biopsy: more dogma belied. Eur Urol. 2015;68(6):1014–5. Epub 2015/05/26CrossRefGoogle Scholar
  19. 19.
    Kutikov A, Smaldone MC, Uzzo RG, Haifler M, Bratslavsky G, Leibovich BC. Renal mass biopsy: always, sometimes, or never? Eur Urol. 2016;70(3):403–6. Epub 2016/04/18CrossRefGoogle Scholar
  20. 20.
    Parker PA, Alba F, Fellman B, Urbauer DL, Li Y, Karam JA, et al. Illness uncertainty and quality of life of patients with small renal tumors undergoing watchful waiting: a 2-year prospective study. Eur Urol. 2013;63(6):1122–7. Epub 2013/02/20CrossRefGoogle Scholar
  21. 21.
    Kockelbergh R, Griffiths L. Renal tumour biopsy–a new standard of care? Eur Urol. 2016;69(4):674–5. Epub 2015/10/03CrossRefGoogle Scholar
  22. 22.
    Rakowski SK, Winterkorn EB, Paul E, Steele DJ, Halpern EF, Thiele EA. Renal manifestations of tuberous sclerosis complex: incidence, prognosis, and predictive factors. Kidney Int. 2006;70(10):1777–82. Epub 2006/09/28CrossRefGoogle Scholar
  23. 23.
    Campbell S, Uzzo RG, Allaf ME, Bass EB, Cadeddu JA, Chang A, et al. Renal mass and localized renal cancer: AUA guideline. J Urol. 2017;198(3):520–9. Epub 2017/05/10CrossRefGoogle Scholar
  24. 24.
    Motzer RJ, Jonasch E, Agarwal N, Bhayani S, Bro WP, Chang SS, et al. Kidney cancer, version 2.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2017;15(6):804–34. Epub 2017/06/10CrossRefGoogle Scholar
  25. 25.
    Ljungberg B, Bensalah K, Canfield S, Dabestani S, Hofmann F, Hora M, et al. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol. 2015;67(5):913–24. Epub 2015/01/27CrossRefGoogle Scholar
  26. 26.
    Dave CN, Seifman B, Chennamsetty A, Frontera R, Faraj K, Nelson R, et al. Office-based ultrasound-guided renal core biopsy is safe and efficacious in the management of small renal masses. Urology. 2017;102:26–30. Epub 2016/12/28CrossRefGoogle Scholar
  27. 27.
    Silverman SG, Collick BD, Figueira MR, Khorasani R, Adams DF, Newman RW, et al. Interactive MR-guided biopsy in an open-configuration MR imaging system. Radiology. 1995;197(1):175–81. Epub 1995/10/01CrossRefGoogle Scholar
  28. 28.
    Uppot RN, Harisinghani MG, Gervais DA. Imaging-guided percutaneous renal biopsy: rationale and approach. AJR Am J Roentgenol. 2010;194(6):1443–9. Epub 2010/05/22CrossRefGoogle Scholar
  29. 29.
    Breda A, Treat EG, Haft-Candell L, Leppert JT, Harper JD, Said J, et al. Comparison of accuracy of 14-, 18- and 20-G needles in ex-vivo renal mass biopsy: a prospective, blinded study. BJU Int. 2010;105(7):940–5. Epub 2009/11/06CrossRefGoogle Scholar
  30. 30.
    Scanga LR, Maygarden SJ. Utility of fine-needle aspiration and core biopsy with touch preparation in the diagnosis of renal lesions. Cancer Cytopathol. 2014;122(3):182–90. Epub 2013/12/20CrossRefGoogle Scholar
  31. 31.
    Yang CS, Choi E, Idrees MT, Chen S, Wu HH. Percutaneous biopsy of the renal mass: FNA or core needle biopsy? Cancer. 2017;125(6):407–15. Epub 2017/03/24Google Scholar
  32. 32.
    Barwari K, Kummerlin IP, ten Kate FJ, Algaba F, Trias I, Wijkstra H, et al. What is the added value of combined core biopsy and fine needle aspiration in the diagnostic process of renal tumours? World J Urol. 2013;31(4):823–7. Epub 2011/06/01CrossRefGoogle Scholar
  33. 33.
    Babaei Jandaghi A, Lebady M, Zamani AA, Heidarzadeh A, Monfared A, Pourghorban R. A randomised clinical trial to compare coaxial and noncoaxial techniques in percutaneous core needle biopsy of renal parenchyma. Cardiovasc Intervent Radiol. 2017;40(1):106–11. Epub 2016/10/04CrossRefGoogle Scholar
  34. 34.
    Hobbs DJ, Zhou M, Campbell SC, Aydin H, Weight CJ, Lane BR. The impact of location and number of cores on the diagnostic accuracy of renal mass biopsy: an ex vivo study. World J Urol. 2013;31(5):1159–64. Epub 2012/04/25CrossRefGoogle Scholar
  35. 35.
    Abel EJ, Heckman JE, Hinshaw L, Best S, Lubner M, Jarrard DF, et al. Multi-quadrant biopsy technique improves diagnostic ability in large heterogeneous renal masses. J Urol. 2015;194(4):886–91. Epub 2015/04/04CrossRefGoogle Scholar
  36. 36.
    Patel HD, Johnson MH, Pierorazio PM, Sozio SM, Sharma R, Iyoha E, et al. Diagnostic accuracy and risks of biopsy in the diagnosis of a renal mass suspicious for localized renal cell carcinoma: systematic review of the literature. J Urol. 2016;195(5):1340–7. Epub 2016/02/24CrossRefGoogle Scholar
  37. 37.
    Leveridge MJ, Finelli A, Kachura JR, Evans A, Chung H, Shiff DA, et al. Outcomes of small renal mass needle core biopsy, nondiagnostic percutaneous biopsy, and the role of repeat biopsy. Eur Urol. 2011;60(3):578–84. Epub 2011/06/28CrossRefGoogle Scholar
  38. 38.
    Bernhard JC, Bigot P, Pignot G, Baumert H, Zini L, Lang H, et al. The accuracy of renal tumor biopsy: analysis from a national prospective study. World J Urol. 2015;33(8):1205–11. Epub 2014/11/07CrossRefGoogle Scholar
  39. 39.
    Salem S, Ponsky LE, Abouassaly R, Cherullo EE, Isariyawongse JP, Maclennan GT, et al. Image-guided biopsy of small renal masses in the era of ablative therapies. Int J Urol. 2013;20(6):580–4. Epub 2012/11/30CrossRefGoogle Scholar
  40. 40.
    Richard PO, Jewett MA, Bhatt JR, Kachura JR, Evans AJ, Zlotta AR, et al. Renal tumor biopsy for small renal masses: a single-center 13-year experience. Eur Urol. 2015;68(6):1007–13. Epub 2015/04/23CrossRefGoogle Scholar
  41. 41.
    Lane BR, Samplaski MK, Herts BR, Zhou M, Novick AC, Campbell SC. Renal mass biopsy—a renaissance? J Urol. 2008;179(1):20–7.CrossRefGoogle Scholar
  42. 42.
    Prince J, Bultman E, Hinshaw L, Drewry A, Blute M, Best S, et al. Patient and tumor characteristics can predict nondiagnostic renal mass biopsy findings. J Urol. 2015;193(6):1899–904. Epub 2014/12/17CrossRefGoogle Scholar
  43. 43.
    Feldman AS, Deshmukh SM, Dhyani M, Barrisford G, Rodriguez D, McGovern FJ, et al. Proposal of an algorithm for utilization of percutaneous renal mass biopsy based on the results of 1000 case series. BJU Int. 2013;112:1–17.Google Scholar
  44. 44.
    Schmidbauer J, Remzi M, Memarsadeghi M, Haitel A, Klingler HC, Katzenbeisser D, et al. Diagnostic accuracy of computed tomography-guided percutaneous biopsy of renal masses. Eur Urol. 2008;53(5):1003–11. Epub 2007/12/07CrossRefGoogle Scholar
  45. 45.
    Marconi L, Dabestani S, Lam TB, Hofmann F, Stewart F, Norrie J, et al. Systematic review and meta-analysis of diagnostic accuracy of percutaneous renal tumour biopsy. Eur Urol. 2016;69(4):660–73. Epub 2015/09/02CrossRefGoogle Scholar
  46. 46.
    Lefaucheur C, Nochy D, Bariety J. Renal biopsy: procedures, contraindications, complications. Nephrol Ther. 2009;5(4):331–9. Epub 2009/04/07CrossRefGoogle Scholar
  47. 47.
    Volpe A, Finelli A, Gill IS, Jewett MA, Martignoni G, Polascik TJ, et al. Rationale for percutaneous biopsy and histologic characterisation of renal tumours. Eur Urol. 2012;62(3):491–504. Epub 2012/05/29CrossRefGoogle Scholar
  48. 48.
    Viswanathan A, Ingimarsson JP, Seigne JD, Schned AR. A single-centre experience with tumour tract seeding associated with needle manipulation of renal cell carcinomas. Can Urol Assoc J = Journal de l'Association des urologues du Canada. 2015;9(11–12):E890–3. Epub 2016/02/03CrossRefGoogle Scholar
  49. 49.
    Corapi KM, Chen JL, Balk EM, Gordon CE. Bleeding complications of native kidney biopsy: a systematic review and meta-analysis. Am J Kidney Dis. 2012;60(1):62–73. Epub 2012/04/28CrossRefGoogle Scholar
  50. 50.
    Ralls PW, Barakos JA, Kaptein EM, Friedman PE, Fouladian G, Boswell WD, et al. Renal biopsy-related hemorrhage: frequency and comparison of CT and sonography. J Comput Assist Tomogr. 1987;11(6):1031–4. Epub 1987/11/01CrossRefGoogle Scholar
  51. 51.
    Whittier WL, Korbet SM. Timing of complications in percutaneous renal biopsy. J Am Soc Nephrol. 2004;15(1):142–7. Epub 2003/12/25CrossRefGoogle Scholar
  52. 52.
    Hopper KD, Yakes WF. The posterior intercostal approach for percutaneous renal procedures: risk of puncturing the lung, spleen, and liver as determined by CT. AJR Am J Roentgenol. 1990;154(1):115–7. Epub 1990/01/01CrossRefGoogle Scholar
  53. 53.
    Ajib KM, Matta IF, Zgheib JT, Jabbour ME. Non-angled intercostal percutaneous access under full expiration: safety is not an issue anymore. J Endourol. 2017. Epub 2017/05/26;31:736.CrossRefGoogle Scholar
  54. 54.
    Pandharipande PV, Gervais DA, Hartman RI, Harisinghani MG, Feldman AS, Mueller PR, et al. Renal mass biopsy to guide treatment decisions for small incidental renal tumors: a cost-effectiveness analysis. Radiology. 2010;256(3):836–46. Epub 2010/08/20CrossRefGoogle Scholar
  55. 55.
    Heilbrun ME, Yu J, Smith KJ, Dechet CB, Zagoria RJ, Roberts MS. The cost-effectiveness of immediate treatment, percutaneous biopsy and active surveillance for the diagnosis of the small solid renal mass: evidence from a Markov model. J Urol. 2012;187(1):39–43. Epub 2011/11/18CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of UrologyMassachusetts General Hospital, Harvard Medical SchoolBostonUSA

Personalised recommendations