Office-Based Ultrasound Guided Renal Core Biopsy is Safe and Efficacious in the Management of Small Renal Masses

Abstract Objectives To evaluate the safety and efficacy of ultrasound guided percutaneous renal mass biopsy (RMB) performed in the office setting by urologists. Methods This is a retrospective study involving patients who underwent office-based ultrasound guided percutaneous RMB between April 2010 and October 2015. Baseline vital signs and ultrasound were performed prior to the procedure. Patients were then observed for 1-hour after the procedure and repeat vital signs and ultrasound were performed. Hemodynamically stable patients without developing hematoma were discharged. Results In 108 patients, 70/108 (64.8%) were male, median age was 69.5 years, median mass size was 3.3 cm (IQR: 2.5-4.6). Biopsy yield was as follows: 72/108 (66.7%) Renal Cell Carcinoma (RCC), 14/108 (13.0%) benign renal parenchyma, 11/108 (10.2%) Oncocytoma, 6/108 (5.6%) Angiomyolipoma, 2/108 (1.9%) Lymphoma, 3/108 (2.8%) other. The initial nondiagnostic rate was 14/108 (13.0%). 28/108 (25.9%) patients were observed while 79/108 (73.2%) received surgery or ablative therapy. Final pathology was concordant with biopsy results in 64/65 (98.4%) cases. Three patients experienced a grade one Clavien-Dindo surgical complication, all of which were managed conservatively. Conclusions Office-based ultrasound guided RMB is safe and efficacious in the management of appropriately selected SRM. It potentially offers improved dynamic characterization of SRM, greater convenience to patients, as well as cost savings. Further studies are needed to evaluate this promising technique.