To review the indications for image guided biopsy of small renal masses and discuss how the biopsy result affects patient management. To discuss the technique for focal renal biopsy,
including choice of imaging modality,
technical aspects and the role of fusion imaging,
correlating with clinical cases.
The increasing use of cross-sectional imaging has resulted in a significant increase in the incidental detection ofsmall renal masses (<2cm) (1).
There is a myriad of differentials for renal masses,
ranging from benign angiomyolipomas (AML) and oncocytomas to the many subtypes of renal cell carcinoma (RCC).Treatment options for small renal masses include discharge (if benign),
ablation and stereotactic radiotherapy.
Given the wide range of treatment...
Findings and procedure details
Indication for small renal mass biopsy: A 2013 report from an international consensus panel at the 5th International Symposium on Focal Therapy and Imaging in Prostate and Kidney Cancer (Tsivian et al.) recommended the use ofsmall renal mass biopsy in certain scenarios (10); Where standard imaging can not specifically characterise a lesion (e.g.
the absence of macroscopic fat on CT for possible angiomyolipoma) (Figure 4). Patients for whomactive surveillance is being considered as the...
Small renal masses incidentally detected on cross-sectional imaging can safely undergo image guided biopsy to provide a tissue diagnosis and plan definitive management.
This prevents unnecessary surgery and improves patient’s outcomes.
Developments in image fusion techniques may allow safer and quicker biopsy procedures with improved diagnostic accuracy for occult lesions.
Contact Details: Dr Roisin Heaney,Radiology Resident Department of Radiology,
St James Hospital,
Ireland. Email: firstname.lastname@example.org
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Imaging features of solid renal masses.
The British journal of radiology.
MR imaging in the characterization of small renal masses.