Purpose

To evaluate the diagnostic yield of percutaneous renal mass biopsy (RMB) before and after ablation.

Materials and methods

In total, 333 renal masses in 332 consecutive patients underwent computed tomography (CT)-guided biopsies and were included in this study. All biopsies were performed with 18-gauge core needles with CT fluoroscopic guidance before ablation (n = 234) or immediately after radiofrequency ablation (RFA) (n = 40) or cryoablation (CA) (n = 59). The safety and diagnostic yield of RMB were evaluated. Both univariate and multivariate analyses were used to identify factors affecting diagnostic yield.

Results

No major complication occurred. The 281 specimens (84%) were diagnostic. There were 257 renal cell carcinomas (77%), 21 benign masses (6%), and 3 metastases (1%). The remaining 52 specimens (16%) were nondiagnostic. The diagnostic yields before ablation, after RFA, and CA were 91% (212/234), 80% (32/40), and 63% (37/59), respectively. Small masses (P = 0.050 and 0.006), cystic masses (P < 0.001 and < 0.001), and post-CA (P < 0.001 and < 0.001) were independent and significant factors affecting the nondiagnostic results in both univariate and multivariate analyses.

Conclusion

CT-guided RMB can be nondiagnostic when the tumor is small, cystic, or biopsied immediately after CA.

中文翻译：

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消融术前或治疗后对小的肾脏肿块进行计算机断层扫描引导活检：影响诊断率的因素

目的

评估消融前后经皮肾穿刺活检的诊断率。

材料和方法

总共332例连续患者中的333个肾肿块接受了计算机断层扫描（CT）引导的活检，并纳入了这项研究。所有活检均在消融之前（n = 234）或射频消融（RFA）（n = 40）或冷冻消融（CA）（n = 59）之后，用18口芯针在CT荧光镜引导下进行。对人民币的安全性和诊断产率进行了评估。单变量和多变量分析均用于确定影响诊断率的因素。

结果

无大并发症发生。281个样本（占84％）具有诊断性。有257例肾细胞癌（77％），21例良性肿块（6％）和3个转移灶（1％）。其余52个标本（16％）未诊断。消融前，RFA和CA后的诊断率分别为91％（212/234），80％（32/40）和63％（37/59）。小质量（P = 0.050和0.006），囊性质量（P  <0.001和<0.001）和CA后（P  <0.001和<0.001）是独立且重要的因素，在单因素和多因素分析中均会影响非诊断结果。

结论

当肿瘤较小，囊性或在CA后立即进行活检时，CT引导的RMB可能无法诊断。