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Atlas of Ultrasonography in Urology, Andrology, and Nephrology pp 159–171Cite as

Interventional Ultrasound: Biopsy of Renal Masses

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Abstract

An increasing number of renal masses with heterogeneous histology and clinical behaviour are being detected with modern radiological imaging. Purpose of this chapter is to provide an analysis of the rationale, indications, technique, safety and outcomes of percutaneous needle core biopsies of renal tumours. Renal tumour biopsies can be performed under ultrasound or CT guidance with local anaesthesia in the majority of cases. Core biopsies using 18G needles with a coaxial technique should be favoured to sample solid renal masses. With the use of modern techniques biopsies are safe, with limited risk of significant bleeding and virtually no risk of tumour seeding. Both diagnostic yield and accuracy for tumor malignancy and histotype are good in centres with expertise. Renal tumor biopsies should be increasingly performed in the diagnostic work-up of renal masses that are indeterminate at imaging, for the histological characterization of small renal masses in patients who are candidates for non surgical management in order to support treatment decisions, after thermal ablation in order to confirm histological success and monitor for recurrence, and in metastatic tumors when a cytoreductive nephrectomy is not indicated in order to select the best suited targeted therapy. Well designed, prospective, large studies are needed to define optimal and standardised patterns of biopsy and further improve the accuracy of biopsies to determine tumour histology. Molecular and genetic analysis of biopsy specimens have the potential to provide additional information to support patient counselling and treatment decision making.

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Authors and Affiliations

  1. Division of Urology, Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, Corso Mazzini, 18 – 28100, Novara, Italy

    Alessandro Volpe MD & Luisa Zegna

Authors
  1. Alessandro Volpe MD
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  2. Luisa Zegna
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Correspondence to Alessandro Volpe MD .

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Editors and Affiliations

  1. Department of Emergency and Organ Transplantation Urology Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy

    Pasquale Martino

  2. Division of Urology, Polytechnic University of Marche, Ancona, Italy

    Andrea B. Galosi

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Volpe, A., Zegna, L. (2017). Interventional Ultrasound: Biopsy of Renal Masses. In: Martino, P., Galosi, A. (eds) Atlas of Ultrasonography in Urology, Andrology, and Nephrology. Springer, Cham. https://doi.org/10.1007/978-3-319-40782-1_13

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  • DOI: https://doi.org/10.1007/978-3-319-40782-1_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-40780-7

  • Online ISBN: 978-3-319-40782-1

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