INTRODUCTION: Systemic targeted therapy options are commonly used in patients with metastatic renal cell carcinoma (mRCC). Histological verification is crucial for treatment of mRCC. AIM: Our aim was to evaluate an optimal location for percutaneous computed tomography‑guided biopsy in a diagnosis of suspected mRCC. MATERIALS AND METHODS: A total of 138 percutaneous biopsies for tumors ranging from 21 to 133 mm in diameter (median, 72 mm) were carried out in 134 patients with suspected mRCC over a 5‑year period. The biopsy location was variable, with kidney biopsy performed in 77 cases (55.8%), and other localizations (retroperitoneum, peritoneal cavity, liver, pelvis, pleural space, lung, mediastinum, chest or abdominal wall, and pancreas) in 61 cases (44.2%). RESULTS: As many as 288 biopsies (97.1%), yielded truepositive results, and 4 procedures (2.9%) yielded histologically falsenegative results that required confirmation through extended rebiopsy. RCC was the most common individual diagnosis (85.5%), with non‑RCC histology verified in 14.5% of cases. In total, 32 complications (23.2%) were confirmed, 2 of which were pneumothoraces, 29 were minor bleeding that needed only conservative management, and 1 case required angiography and embolization for hemorrhage treatment. While no significant relationship between the biopsy success and lesion localization (renal vs other) was found (P = 0.13), the relationship between complication rate and biopsy localization (renal vs other) was significant (P = 0.01). CONCLUSIONS: Lesion localization (renal vs other) was not relevant to histological accuracy of the biop‑ sies performed in patients with suspected mRCC. However, the biopsies of lesions outside the kidney had a lower complication rate.

Department of Oncology and Radiotherapy Faculty of Medicine and University Hospital Charles University Hradec Kralove Czech Republic

Department of Radiology Faculty of Medicine and University Hospital Charles University Hradec Kralove Czech Republic

Department of Urology Faculty of Medicine and University Hospital Charles University Hradec Kralove Czech Republic

Faculty of Education Charles University Prague Czech Republic

Zobrazit více v PubMed

Epidemiology of renal cell carcinoma. Capitanio U., Bensalah K., Bex A. Eur Urol. 2019;75:74-84. PubMed PMC

Epidemiology of renal cell carcinoma: 2022 update. Bukavina L., Bensalah K., Bray F. Eur Urol. 2022;82:529-542. PubMed

Clinical review on the management of metastatic renal cell carcinoma. Tran J., Ornstein M.C. JCO Oncol Pract. 2022;18:187-196. PubMed

Epidemiology of renal cell carcinoma. Padala S.A., Barsouk A., Thandra K.C. World J Oncol. 2020;11:79-87. PubMed PMC

Sunitinib alone or after nephrectomy in metastatic renal-cell carcinoma. Méjean A., Ravaud A., Thezenas S. N Engl J Med. 2018;379:417-427. PubMed

Current clinical practice guidelines for the treatment of renal cell carcinoma: a systematic review and critical evaluation. Bamias A., Escudier B., Sternberg C.N. Oncologist. 2017;22:667-679. PubMed PMC

European Association of Urology guidelines on renal cell carcinoma: the 2022 update. Ljungberg B., Albiges L., Abu-Ghanem Y. Eur Urol. 2022;82:399-410. PubMed

Management of the small renal mass: a 2020 update. RN Wilcox Vanden Berg, SP Basourakos, S LaRussa, TD McClure. Curr Oncol Rep. 2020;22 PubMed

Hoppe R.T., Phillips T.L., Roach M. Saunders: 2010. Leibel and Phillips Textbook of Radiation Oncology; pp. 1601-1641.

Laparoscopic versus open radical nephrectomy: a 9-year experience. Dunn M.D., Portis A.J., Shalhav A.L. J Urol. 2000;164:1153-1159. PubMed

Robotic radical nephrectomy for renal cell carcinoma: a systematic review. Asimakopoulos A.D., Miano R., Annino F. BMC Urol. 2014;14 PubMed PMC

Nephron sparing surgery for renal tumors: indications, techniques and outcomes. Uzzo R.G., Novick A.C. J Urol. 2001;166:6-18. PubMed

Chemotherapy for renal cell carcinoma. Hartmann J.T., Bokemeyer C. Anticancer Res. 1999;19:1541-1543. PubMed

Radiotherapy and renal cell carcinoma: a continuing saga. Spyropoulou D., Tsiganos P., Dimitrakopoulos F.I. Vivo. 2021;35:1365-1377. PubMed PMC

Position of cytoreductive nephrectomy in the setting of metastatic renal cell carcinoma patients: does the CARMENA trial lead to a paradigm shift? Dariane C., Timsit M.O., Méjean A. Bull Cancer. 2018;105:229-234. PubMed

The LMR-SSIGN-MAPS model predicts disease-free survival in patients with localized clear cell renal cell carcinoma. Wen H., Zhang Y., Yang Z. Wideochir Inne Tech Maloinwazyjne. 2023;18:313-327. PubMed PMC

Diagnostic accuracy and risks of biopsy in the diagnosis of a renal mass suspicious for localized renal cell carcinoma: systematic review of the literature. Patel H.D., Johnson M.H., Pierorazio P.M. J Urol. 2016;195:1340-1347. PubMed PMC

Systematic review and meta-analysis of diagnostic accuracy of percutaneous renal tumour biopsy. Marconi L., Dabestani S., Lam T.B. Eur Urol. 2016;69:660-673. PubMed

Role of percutaneous needle biopsy for renal masses. Caoili E.M., Davenport M.S. Semin Intervent Radiol. 2014;31:20-26. PubMed PMC

Renal tumor biopsy: rationale to avoid surgery in small renal masses. Amaral B.S., Macek P., Arora A. Curr Urol Rep. 2021;22 PubMed

Multi-quadrant biopsy technique improves diagnostic ability in large heterogeneous renal masses. Abel E.J., Heckman J.E., Hinshaw L. J Urol. 2015;194:886-891. PubMed

Core needle biopsy and fine needle aspiration alone or in combination: diagnostic accuracy and impact on management of renal masses. Cate F., Kapp M.E., Arnold S.A. J Urol. 2017;197:1396-1402. PubMed PMC

Contrast enhanced ultrasound guidance: a new tool to improve accuracy in percutaneous biopsies. Spârchez Z., Radu P., Zaharia T. Med Ultrason. 2010;12:133-138. PubMed

Role of renal mass biopsy for diagnosis and management: review of current trends and future directions. Choy B., Nayar R., Lin X. Cancer Cytopathol. 2023;131:480-494. PubMed

Percutaneous CT-guided abdominal and pelvic biopsies: comparison of an electromagnetic navigation system and CT fluoroscopy. Zlevor A.M., Kisting M.A., Couillard A.B. J Vasc Interv Radiol. 2023;34:910-918. PubMed

Core needle biopsy guidance based on tissue morphology assessment with AI-OCT imaging. Maguluri G., Grimble J., Caron A. Diagnostics (Basel. 2023;13 PubMed PMC

Computed tomography-guided percutaneous biopsy for retroperitoneal lesions: a systematic review and meta-analysis. Matsumoto T., Yoshimatsu R., Miyatake K. Minim Invasive Ther Allied Technol. 2022;31:1000-1007. PubMed

Computed tomography-guided percutaneous biopsy of isoattenuating focal liver lesions. Sainani N.I., Schlett C.L., Hahn P.F. Abdom Imaging. 2014;39:633-644. PubMed

Computed tomography-guided lung biopsy: a review of techniques for reducing the incidence of complications. Nakamura K., Matsumoto K., Inoue C. Interv Radiol (Higashimatsuyama. 2021;6:83-92. PubMed PMC

Percutaneous CT-guided bone biopsies: indications, feasibility and diagnostic yield in the different skeletal sites-from the skull to the toe. Spinnato P., Colangeli M., Rinaldi R., Ponti F. Diagnostics (Basel. 2023;13 PubMed PMC

Clinical utility of image-guided peritoneal and omental biopsy. Spencer J.A., Weston M.J., Saidi S.A. Nat Rev Clin Oncol. 2010;7:623-631. PubMed

Value of CT fluoroscopy for percutaneous biopsy procedures. Gianfelice D., Lepanto L., Perreault P. J Vasc Interv Radiol. 2000;11:879-884. PubMed

Diagnostic yield and complication rate in percutaneous needle biopsy of renal hilar masses with comparison with renal cortical mass biopsies in a cohort of 195 patients. Cooper S., Flood T.A., Khodary M.E. AJR Am J Roentgenol. 2019;212:570-575. PubMed

Complications of percutaneous renal biopsy. Bakdash K., Schramm K.M., Annam A. Semin Intervent Radiol. 2019;36:97-103. PubMed PMC

Tumour seeding in the tract of percutaneous renal tumour biopsy: a report on seven cases from a UK tertiary referral centre. Macklin P.S., Sullivan M.E., Tapping C.R. Eur Urol. 2019;75:861-867. PubMed