title: Small renal mass biopsy--how, what and when: report from an international consensus panel.
abstract: To discuss the use of renal mass biopsy (RMB) for small renal masses (SRMs), formulate technical aspects, outline potential pitfalls and provide recommendations for the practicing clinician. The meeting was conducted as an informal consensus process and no scoring system was used to measure the levels of agreement on the different topics. A moderated general discussion was used as the basis for consensus and arising issues were resolved at this point. A consensus was established and lack of agreement to topics or specific items was noted at this point. Recommended biopsy technique: at least two cores, sampling different tumour regions with ultrasonography being the preferred method of image guidance. Pathological interpretation: 'non-diagnostic samples' should refer to insufficient material, inconclusive and normal renal parenchyma. For non-diagnostic samples, a repeat biopsy is recommended. Fine-needle aspiration may provide additional information but cannot substitute for core biopsy. Indications for RMB: biopsy is recommended in most cases except in patients with imaging or clinical characteristics indicative of pathology (syndromes, imaging characteristics) and cases whereby conservative management is not contemplated. RMB is recommended for active surveillance but not for watchful-waiting candidates. We report the results of an international consensus meeting on the use of RMB for SRMs, defining the technique, pathological interpretation and indications.
authors.affiliation: Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
authors.forename: Matvey
authors.initials: M
authors.lastname: Tsivian
authors.forename: Edward N
authors.initials: EN
authors.lastname: Rampersaud
authors.forename: Maria
authors.initials: M
authors.lastname: del Pilar Laguna Pes
authors.forename: Steven
authors.initials: S
authors.lastname: Joniau
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Leveillee
authors.forename: William B
authors.initials: WB
authors.lastname: Shingleton
authors.forename: Monish
authors.initials: M
authors.lastname: Aron
authors.forename: Charles Y
authors.initials: CY
authors.lastname: Kim
authors.forename: Angelo M
authors.initials: AM
authors.lastname: DeMarzo
authors.forename: Mihir M
authors.initials: MM
authors.lastname: Desai
authors.forename: James D
authors.initials: JD
authors.lastname: Meler
authors.forename: James F
authors.initials: JF
authors.lastname: Donovan
authors.forename: Hans Christoph
authors.initials: HC
authors.lastname: Klingler
authors.forename: David R
authors.initials: DR
authors.lastname: Sopko
authors.forename: John F
authors.initials: JF
authors.lastname: Madden
authors.forename: Michael
authors.initials: M
authors.lastname: Marberger
authors.forename: Michael N
authors.initials: MN
authors.lastname: Ferrandino
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Polascik
mesh_terms: D001707:Biopsy, Needle / Q000379:methods / Q000592:standards; D006801:Humans; D007674:Kidney Diseases / Q000473:pathology*; D007680:Kidney Neoplasms / Q000473:pathology*; D015203:Reproducibility of Results
keywords: ablation; biopsy; consensus; renal cell carcinoma (RCC); renal mass biopsy; small renal mass