title: CT-guided Native Medical Renal Biopsy: Cortical Tangential versus Non-Tangential Approaches-A Comparison of Efficacy and Safety.
abstract: Purpose To review a single-center experience with the cortical tangential approach during computed tomography (CT)-guided native medical renal biopsy and to evaluate its efficacy and safety compared with those of a non-cortical tangential approach. Materials and Methods This retrospective study received institutional review board approval, with a waiver of the HIPAA requirement for informed consent. The number of cores, glomeruli, and complications were reviewed in 431 CT-guided medical renal biopsies performed between July 2007 and September 2015. A biopsy followed a cortical tangential approach if the needle path was parallel to the renal cortical surface, at a depth closer to the renal capsule than the renal pelvic fat. A sample was considered adequate if the biopsy yielded at least 10 glomeruli at light microscopy, one glomerulus at immunofluorescence microscopy, and one glomerulus at electron microscopy. The χ2test, the t test, the Mann-Whitney test, and logistic regression modeling of sample adequacy were performed. Results One hundred fifty-six (36%) of 431 biopsies were performed with the cortical tangential approach. More cores were obtained for the cortical tangential group (2.6 vs 2.4, P = .001); biopsy needle gauge was not significantly different (P = .076). More adequate samples were obtained in the cortical tangential group (66.7% vs 49.8%, P = .001), with more glomeruli (23 vs 16, P = .014). Results were significant after controlling for needle gauge and number of cores (P = .008). The cortical tangential group had fewer complications (1.9% vs 7.3%, P = .018). Conclusion The cortical tangential approach, when applied to CT-guided native medical renal biopsies, results in higher rates of sample adequacy and lower rates of postprocedural complications.©RSNA, 2016.
authors.affiliation: From the Departments of Radiology (B.L., M.O., M.F., J.L., M.K., J.B., F.C., A.L., T.J.W.) and Biostatistics (J.P.), Florida Hospital, 601 E Rollins St, Orlando, FL 32803.
authors.forename: Bo
authors.initials: B
authors.lastname: Liu
authors.affiliation: From the Departments of Radiology (B.L., M.O., M.F., J.L., M.K., J.B., F.C., A.L., T.J.W.) and Biostatistics (J.P.), Florida Hospital, 601 E Rollins St, Orlando, FL 32803.
authors.forename: Matthew
authors.initials: M
authors.lastname: O'Dell
authors.affiliation: From the Departments of Radiology (B.L., M.O., M.F., J.L., M.K., J.B., F.C., A.L., T.J.W.) and Biostatistics (J.P.), Florida Hospital, 601 E Rollins St, Orlando, FL 32803.
authors.forename: Miguel
authors.initials: M
authors.lastname: Flores
authors.affiliation: From the Departments of Radiology (B.L., M.O., M.F., J.L., M.K., J.B., F.C., A.L., T.J.W.) and Biostatistics (J.P.), Florida Hospital, 601 E Rollins St, Orlando, FL 32803.
authors.forename: Joseph
authors.initials: J
authors.lastname: Limback
authors.affiliation: From the Departments of Radiology (B.L., M.O., M.F., J.L., M.K., J.B., F.C., A.L., T.J.W.) and Biostatistics (J.P.), Florida Hospital, 601 E Rollins St, Orlando, FL 32803.
authors.forename: Melissa
authors.initials: M
authors.lastname: Kendall
authors.affiliation: From the Departments of Radiology (B.L., M.O., M.F., J.L., M.K., J.B., F.C., A.L., T.J.W.) and Biostatistics (J.P.), Florida Hospital, 601 E Rollins St, Orlando, FL 32803.
authors.forename: Julie
authors.initials: J
authors.lastname: Pepe
authors.affiliation: From the Departments of Radiology (B.L., M.O., M.F., J.L., M.K., J.B., F.C., A.L., T.J.W.) and Biostatistics (J.P.), Florida Hospital, 601 E Rollins St, Orlando, FL 32803.
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: Burt
authors.affiliation: From the Departments of Radiology (B.L., M.O., M.F., J.L., M.K., J.B., F.C., A.L., T.J.W.) and Biostatistics (J.P.), Florida Hospital, 601 E Rollins St, Orlando, FL 32803.
authors.forename: Francisco
authors.initials: F
authors.lastname: Contreras
authors.affiliation: From the Departments of Radiology (B.L., M.O., M.F., J.L., M.K., J.B., F.C., A.L., T.J.W.) and Biostatistics (J.P.), Florida Hospital, 601 E Rollins St, Orlando, FL 32803.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Lewis
authors.affiliation: From the Departments of Radiology (B.L., M.O., M.F., J.L., M.K., J.B., F.C., A.L., T.J.W.) and Biostatistics (J.P.), Florida Hospital, 601 E Rollins St, Orlando, FL 32803.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Ward
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology*; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult