title: Sonographically guided transhepatic core biopsies of right renal and adrenal masses: safety and short-term follow-up.
abstract: OBJECTIVE
  The purpose of this study was to retrospectively evaluate the accuracy and safety of sonographically guided transhepatic biopsies of right upper renal and adrenal masses.
  
  
  METHODS
  Ten sonographically guided transhepatic biopsies were performed in 10 patients with 6 right upper renal masses and 4 right adrenal masses that were invisible or inaccessible via an extrahepatic route. The control population comprised 19 sonographically guided extrahepatic biopsies that were performed in 19 patients with 18 right upper renal masses and 1 right adrenal mass. Transhepatic and extrahepatic biopsies were compared with respect to the diagnostic and complication rates. The mass sizes, biopsy distances, numbers and lengths of cores, and biopsy durations were also compared.
  
  
  RESULTS
  The diagnostic rates of transhepatic and extrahepatic biopsies were 90% (9 of 10) and 89% (17 of 19), respectively (P > .999). The complication rates of transhepatic and extrahepatic biopsies were 10% (1 of 10) and 21% (4 of 19; P > .999). None of these biopsies resulted in major complications. The mean mass sizes, biopsy distances, and numbers of cores ± SD for transhepatic and extrahepatic biopsies were 33.0 ± 14.3 and 46.9 ± 18.5 mm, 100.5 ± 17.9 and 76.5 ± 9.9 mm, and 2.7 ± 0.9 and 4.0 ± 0.7, respectively (P = .046, .038, and .001). However, the core lengths and biopsy durations were not significantly different between these biopsies (P = .91 and .077).
  
  
  CONCLUSIONS
  Sonographically guided transhepatic core biopsies appear to be feasible and safe procedures for the histologic diagnosis of right upper renal and adrenal masses that are either invisible or inaccessible via an extrahepatic route.
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, Korea. rapark@skku.edu.
authors.forename: Sung Yoon
authors.initials: SY
authors.lastname: Park
authors.forename: Byung Kwan
authors.initials: BK
authors.lastname: Park
authors.forename: Chan Kyo
authors.initials: CK
authors.lastname: Kim
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D000368:Aged; D062005:Biopsy, Large-Core Needle / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000379:methods*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: adrenal gland; biopsy; kidney; sonography; transhepatic