Time course of complications after small renal mass biopsy: evaluation of initial follow-up images

Jpn J Radiol. 2024 Apr;42(4):398-405. doi: 10.1007/s11604-023-01509-9. Epub 2023 Nov 22.

Abstract

Purpose: To retrospectively assess the time course of complications after image-guided small renal mass biopsy using initial follow-up imaging.

Materials and methods: A total of 190 masses (mean, 2.1 ± 0.70 cm; range, 0.6-3.8 cm) were assessed using initial computed tomography (43 non-enhanced and 141 enhanced) or magnetic resonance imaging (five non-enhanced and one enhanced) after biopsy. Initial follow-up imaging was classified into two groups (i.e., with or without hematoma) and various factors were compared.

Results: The masses were histologically diagnosed in all patients except one. Post-procedural complications included 129 Grade I hematomas, 1 Grade I hemothorax, 9 Grade II hematomas, and 1 Grade IIIa pneumothorax. Residual 28 Grade I and 6 Grade II hematomas and 8 new complications (6 small hematomas, 1 pseudoaneurysm, and 1 arteriovenous fistula) were observed on the initial follow-up imaging obtained at a median of 21 days (3-90 days) after the biopsy. On the initial follow-up imaging, the groups with and without hematoma differed significantly in the following factors: age (P = 0.04), size (P = 0.02), guided images (P < 0.01), hematoma at the end of the procedure (P < 0.01), and days after biopsy (P < 0.01). Although three masses exhibited > 25% shrinkage, no significant change was observed in mass diameter on initial follow-up imaging (mean, 2.1 ± 0.71 cm; P = 0.90).

Conclusion: Initial follow-up imaging after a biopsy revealed improvements in most of the complications, a few new complications, and an unchanged mass diameter.

Keywords: Biopsy; Complication; Imaging; Renal neoplasms.

MeSH terms

  • Biopsy / adverse effects
  • Follow-Up Studies
  • Hematoma / diagnostic imaging
  • Hematoma / etiology
  • Humans
  • Image-Guided Biopsy / adverse effects
  • Kidney Neoplasms* / diagnostic imaging
  • Kidney Neoplasms* / surgery
  • Retrospective Studies