title: Simultaneous biopsy and radiofrequency ablation of T1a renal cell carcinoma.
abstract: OBJECTIVE
  The goal of this study was to retrospectively evaluate the outcome, including feasibility, safety, diagnostic yield, and factors affecting the success of computed tomography fluoroscopy-guided biopsy when performed during the same procedure than radiofrequency ablation (RFA) in renal tumors strongly suspected of being T1a renal cell carcinoma (RCC).
  
  
  METHODS
  Nineteen patients (13 men, 6 women; mean age, 66.7 years) with a total of 19 suspected renal tumors (mean diameter, 1.8cm) underwent computed tomography fluoroscopy-guided biopsy during (n=6) or immediately after (n=13) RFA. All patients were strongly suspected of having RCC on the basis of patient's medical histories and/or the results of imaging investigations. All procedures were divided into diagnostic and non-diagnostic biopsies. Various variables were compared between the 2 groups using univariate analysis.
  
  
  RESULTS
  In all tumors, biopsy procedures were technically feasible. No major complications were observed, except for 8 minor post-procedural bleedings. All but one tumor was completely ablated. Local recurrence in the ablation zone as well as tumor seeding in retroperitoneal fat occurred in 1 patient 8.5months after the procedure and were successfully treated with further percutaneous cryoablation. Thirteen tumors were diagnosed as RCC, whereas 6 were ultimately found to contain normal renal tissue (n=5) or connective tissue (n=1). Univariate analysis revealed that none of the variables were significantly different between the diagnostic and non-diagnostic biopsies.
  
  
  CONCLUSIONS
  The performance of renal tumor biopsy and RFA in the same session is feasible and safe. Although pre-treatment pathological diagnosis would be generally desirable, simultaneous biopsy with RFA can be an option for the patients who are not amenable to pre-treatment biopsy.
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku Okayama 700-8558, Japan. Electronic address: iguchi@ba2.so-net.ne.jp.
authors.forename: T
authors.initials: T
authors.lastname: Iguchi
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku Okayama 700-8558, Japan. Electronic address: takaoh@tc4.so-net.ne.jp.
authors.forename: T
authors.initials: T
authors.lastname: Hiraki
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku Okayama 700-8558, Japan. Electronic address: me12059@yahoo.co.jp.
authors.forename: K
authors.initials: K
authors.lastname: Tomita
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku Okayama 700-8558, Japan. Electronic address: gobara@cc.okayama-u.ac.jp.
authors.forename: H
authors.initials: H
authors.lastname: Gobara
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku Okayama 700-8558, Japan. Electronic address: hirofujiwar@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku Okayama 700-8558, Japan. Electronic address: sakurai-jun@okayama-u.ac.jp.
authors.forename: J
authors.initials: J
authors.lastname: Sakurai
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku Okayama 700-8558, Japan. Electronic address: wckyh140@yahoo.co.jp.
authors.forename: Y
authors.initials: Y
authors.lastname: Matsui
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku Okayama 700-8558, Japan. Electronic address: susumu@cc.okayama-u.ac.jp.
authors.forename: S
authors.initials: S
authors.lastname: Kanazawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Biopsy; Radiofrequency ablation; Renal cell carcinoma