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Am Fam Physician. 1999;60(3):934

The use of image-guided biopsy has played a limited role in the evaluation of renal masses. Intervention is based on the appearance of renal masses on imaging tests. Because of this, any renal mass that was labeled as suspicious required surgical intervention. With recent advances in computed tomographic (CT) technology, more renal masses are being labeled as suspicious. Wood and associates retrospectively studied the indications, complications and outcomes of image-guided biopsy in patients with renal masses.

Seventy-nine image-guided renal mass biopsies were reviewed in this retrospective study of 73 patients. Fifty-seven of the masses were solid, and 22 were complex cystic or mixed cystic/solid masses. The images, histologic findings and clinical features of the masses were reviewed, and management changes from planned surgical intervention were recorded. Patients were followed after the procedure to determine outcome.

A definitive diagnosis was made for 94 percent of the masses after the image-guided renal biopsy. Forty-nine masses were malignant; 25 were negative for any malignancy. Treatment plans changed from surgical intervention to nonsurgical treatment in 44 percent of the patients. No major complications occurred during any of the procedures. The most common indication for image-guided renal mass biopsy was the presence of a solid or complex mass found during imaging studies.

The authors conclude that image-guided biopsies are not only safe in patients with solid or complex renal masses, but that this procedure can reduce the number of surgical interventions in these patients. The procedure also is reliable in assisting physicians in the diagnosis of renal masses.

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