1062. Image-Guided Percutaneous Biopsy of Cystic Renal Masses: Assessment of Technique, Diagnostic Yield, and Complications
Authors * Denotes Presenting Author
  1. Vellia Zhou *; Tufts University School of Medicine
  2. Emiliano Garza Frias; Massachusetts General Hospital
  3. Ronald Arellano; Massachusetts General Hospital
To report on the diagnostic yield and therapeutic implications of image-guided percutaneous biopsy of cystic renal masses.

Materials and Methods:
A retrospective analysis of 22 patients (mean age 73.1, range 59-85) with 23 complex cystic renal lesions who underwent CT-guided percutaneous biopsy between 2015 and 2022 was conducted. Biopsies were performed using coaxial technique with a 17-g coaxial needle guide. Cyst fluid and core biopsy specimens were obtained and sent for pathologic analysis. Patient information, such as age, gender, tumor size, R.E.N.A.L score, and Bosniak classification, were collected. Technical success, diagnostic yield, and sensitivity were calculated. Complications were determined.

The technical success rate was 100%. Diagnosis of renal cell carcinoma (RCC) was established by core biopsy in 18 cases (78.3%). Of the 8 patients whose aspirated cyst contents were sent for analysis, 5 were diagnostic (62.5%). Of these 5 cases, 3 were concordant with the core biopsy diagnosis of RCC (60%), and 2 were discordant and reported no malignant cellularity (40%). There were 3 complications (13%), two instances of Clavien-Dindo I/SIR A and one instance of Clavien-Dindo II/SIR A. There were no incidents of cyst rupture at the time of biopsy. All biopsy-proven renal cell carcinomas were treated with percutaneous thermal ablation.

Computed tomography-guided percutaneous biopsy of complex cystic renal masses has a diagnostic yield of 78.4% and low complication rate. Image-guided biopsy of complex cystic renal masses should be considered when determining patient management and treatment options.