Accuracy of Percutaneous Core Biopsy in the Diagnosis of Small Renal Masses (≤ 4.0 cm): A Meta-analysis.
OBJECTIVE
To use meta-analysis to determine the accuracy of percutaneous core needle biopsy in the diagnosis of small renal masses (SMRs ≤ 4.0 cm).


METHODS
Studies were identified by searching PubMed, Embase, and the Cochrane Library database up to March 2013. Two of the authors independently assessed the study quality using QUADAS-2 tool and extracted data that met the inclusion criteria. The sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR) and also summary receiver operating characteristic (SROC) curve were investigated and draw. Deek's funnel plot was used to evaluate the publication bias.


RESULTS
A total of 9 studies with 788 patients (803 biopsies) were included. Failed biopsies without repeated or aborted from follow-up/surgery result were excluded (232 patients and 353 biopsies). For all cases, the pooled sensitivity was 94.0% (95% CI: 91.0%, 95.0%), the pooled positive likelihood was 22.57 (95 % CI: 9.20-55.34), the pooled negative likelihood was 0.09 (95 % CI: 0.06-0.13), the pooled DOR was 296.52(95 % CI: 99. 42-884.38). The area under the curve of SROC analysis was 0.959 ± 0.0254.


CONCLUSIONS
Imaging-guided percutaneous core needle biopsy of small renal masses (SMRs ≤ 4.0 cm) is highly accurate to malignant tumor diagnosis with unknown metastatic status and could be offered to some patients after clinic judgment prior to surgical intervention consideration.
Department of Urology, Key laboratory of disease of Urological systems, Gansu Nepho-Urological clinical Center, Second hospital of Lanzhou University, Lanzhou, Gansu, China.|Department of Urology, University Hospitals Case Medicine Center, Case Western Reserve University, Cleveland, OH, USA.
Qiqi
Q
He
Tulane School of Public Health and Tropical Medicine, New Orleans, USA.
Hanzhang
H
Wang
Department of Urology, University Hospitals Case Medicine Center, Case Western Reserve University, Cleveland, OH, USA.
Jonathan
J
Kenyon
Department of Urology, University Hospitals Case Medicine Center, Case Western Reserve University, Cleveland, OH, USA.
Guiming
G
Liu
Department of Urology, Key laboratory of disease of Urological systems, Gansu Nepho-Urological clinical Center, Second hospital of Lanzhou University, Lanzhou, Gansu, China.
Li
L
Yang
Department of Urology, Key laboratory of disease of Urological systems, Gansu Nepho-Urological clinical Center, Second hospital of Lanzhou University, Lanzhou, Gansu, China.
Junqiang
J
Tian
Department of Urology, Key laboratory of disease of Urological systems, Gansu Nepho-Urological clinical Center, Second hospital of Lanzhou University, Lanzhou, Gansu, China.
Zhongjin
Z
Yue
Department of Urology, Key laboratory of disease of Urological systems, Gansu Nepho-Urological clinical Center, Second hospital of Lanzhou University, Lanzhou, Gansu, China.
Zhiping
Z
Wang
D062005:Biopsy, Large-Core Needle / Q000379:methods*; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D016017:Odds Ratio; D017594:Publication Bias; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment