Nabi, Ghulam, Nicolson, Donald J., Tait, Campbell, El-Mokadem, Ishmail, Chuen, Chi and Baker, L. (Lee). (2011) Evidence based recommendations for examining the usefulness of image guided renal biopsies in the management of small/indeterminate renal mass. Journal of Endourology, Vol.25 (Suppl.1). A67-A68. ISSN 0892-7790

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Abstract

We undertook a systematic review of studies examining the usefulness of Image Guided Biopsy (IGB) for in indeterminate and small renal masses. We investigate the methodological difficulties in conducting the systematic review and provide recommendations for quality improvement in future studies evaluating IGB. Methods: We included 36 studies that enrolled adults with suspected renal masses on imaging, and measured one or more of the following outcomes: Diagnostic accuracy of image-guided biopsy compared to final histopathological outcome following surgical procedure or follow-up imaging for at least 5 years. Improvement of diagnostic accuracy using additional or adjunctive histopathological techniques. Adverse events: The index test was IGB: ultrasound, computerised tomography, or magnetic resonance imaging. The reference standard was histopathology of the final specimen (radical nephrectomy or nephron sparing surgery), or at least five years follow-up of imaging results. Study quality was examined using a validated checklist. Results: The studies were poorly reported; and had problems with several methodological features: Less than optimal follow-up for determining change in a mass identified by biopsy; Failure to independently outcome assess, spectrum bias; Unclear reporting of withdrawals; Dissimilar comparisons; and conclusions based on premature follow-up. Because they were poorly conducted, the usefulness of IGB for renal masses remains unclear. Conclusions: The methodological scrutiny of studies reporting on image guided biopsies in small renal masses showed many flaws and forms the basis of recommendations for future areas of improvement in conducting and reporting of studies on this topic.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Kidneys -- Biopsy, Computer-assisted surgery, Evidence-based medicine
Journal or Publication Title:	Journal of Endourology
Publisher:	Mary Ann Liebert Inc.
ISSN:	0892-7790
Date:	November 2011
Volume:	Vol.25
Number:	Suppl.1
Page Range:	A67-A68
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
Description:	29th World Congress of Endourology & SWL WCE 2011
URI:	http://wrap.warwick.ac.uk/id/eprint/40405

Data sourced from Thomson Reuters' Web of Knowledge

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