Tips from Other Journals

Is Image-Guided Biopsy Accurate in the Diagnosis of Renal Masses?


FREE PREVIEW. AAFP members and paid subscribers: Log in to get free access. All others: Purchase online access.

FREE PREVIEW. Purchase online access to read the full version of this article.

Am Fam Physician. 2000 Jul 15;62(2):438-440.

Most renal masses can be diagnosed by imaging techniques, but when the nature of the lesion is not distinguishable on imaging, definitive diagnosis often requires biopsy. Richter and associates assessed the diagnostic accuracy of image-guided biopsy of renal masses that were indeterminate by noninvasive imaging techniques.

The retrospective study included 517 cases of renal masses that required image-guided biopsy because of indeterminate findings on renal imaging. Computed tomographic (CT)–guided biopsy was performed in 245 patients, ultrasound-guided biopsy in 82 patients and fluoroscopically controlled biopsy in 190 patients. The authors evaluated the accuracy of CT- and ultrasound-guided biopsy. Patients were followed for five years after the biopsy if the lesion was benign. If the results suggested malignancy, surgical exploration was performed at the time of the biopsy.

CT-guided biopsy led to a diagnosis in 214 (87 percent) of the 245 patients who underwent this procedure. In the 82 patients who underwent ultrasound-guided biopsy, a diagnosis was made in 54 (65.8 percent). Overall, CT- or ultrasound-guided biopsy established a diagnosis in 76.4 percent of the patients. Follow-up revealed that the diagnosis proved to be inaccurate in 1.4 percent of the cases. In 23.5 percent of the patients, the image-guided biopsy was unable to assist a definitive diagnosis with acceptable confidence, and surgical exploration was required.

The authors conclude that a CT-guided biopsy of a renal mass considered to be indeterminate on imaging studies is a safe and reliable method of establishing a diagnosis in most cases. Use of the image-guided biopsy can significantly reduce the management problems physicians face when evaluating patients with renal masses that cannot be definitively identified as solid or cystic.

Richter F, et al. Accuracy of diagnosis by guided biopsy of renal mass lesions classified indeterminate by imaging studies. Urology. March 2000;55:348–52.


Copyright © 2000 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions

Information From Industry

Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article