CT-guided native medical renal biopsy: Cortical tangential versus non-tangential approaches - A comparison of efficacy and safety

Bo Liu, Matthew O'Dell, Miguel Flores, Joseph Limback, Melissa Kendall, Julie Pepe, Jeremy R. Burt, Francisco Contreras, Andrew R. Lewis, Thomas J. Ward

Research output: Contribution to journalArticle

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 χ2 test, 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.

Original languageEnglish (US)
Pages (from-to)293-299
Number of pages7
JournalRadiology
Volume283
Issue number1
DOIs
StatePublished - Apr 1 2017
Externally publishedYes

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Tomography
Kidney
Biopsy
Safety
Needles
Health Insurance Portability and Accountability Act
Research Ethics Committees
Needle Biopsy
Informed Consent
Fluorescence Microscopy
Capsules
Microscopy
Electron Microscopy
Retrospective Studies
Logistic Models
Fats
Light

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

CT-guided native medical renal biopsy : Cortical tangential versus non-tangential approaches - A comparison of efficacy and safety. / Liu, Bo; O'Dell, Matthew; Flores, Miguel; Limback, Joseph; Kendall, Melissa; Pepe, Julie; Burt, Jeremy R.; Contreras, Francisco; Lewis, Andrew R.; Ward, Thomas J.

In: Radiology, Vol. 283, No. 1, 01.04.2017, p. 293-299.

Research output: Contribution to journalArticle

Liu, B, O'Dell, M, Flores, M, Limback, J, Kendall, M, Pepe, J, Burt, JR, Contreras, F, Lewis, AR & Ward, TJ 2017, 'CT-guided native medical renal biopsy: Cortical tangential versus non-tangential approaches - A comparison of efficacy and safety', Radiology, vol. 283, no. 1, pp. 293-299. https://doi.org/10.1148/radiol.2016160912
Liu, Bo ; O'Dell, Matthew ; Flores, Miguel ; Limback, Joseph ; Kendall, Melissa ; Pepe, Julie ; Burt, Jeremy R. ; Contreras, Francisco ; Lewis, Andrew R. ; Ward, Thomas J. / CT-guided native medical renal biopsy : Cortical tangential versus non-tangential approaches - A comparison of efficacy and safety. In: Radiology. 2017 ; Vol. 283, No. 1. pp. 293-299.
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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 χ2 test, 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.",
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AU - O'Dell, Matthew

AU - Flores, Miguel

AU - Limback, Joseph

AU - Kendall, Melissa

AU - Pepe, Julie

AU - Burt, Jeremy R.

AU - Contreras, Francisco

AU - Lewis, Andrew R.

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N2 - 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 χ2 test, 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.

AB - 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 χ2 test, 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.

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