ArticleAbdominal radiology (New York)2026
Immediate percutaneous renal mass biopsy following cryoablation: validation of diagnostic performance and clinical outcomes.
Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesImage-guided thermal ablation is a guideline-supported treatment for small renal tumors. While biopsy is recommended, the optimal timing relative to ablation remains undefined. Pre-ablation biopsy may complicate ablation through hemorrhage, impaired target visualization, and potential tumor seeding. Post-cryoablation biopsy has been described in a small cohort of patients, but reproducibility has not been established. This study evaluated the diagnostic performance and clinical outcomes of renal mass biopsy performed immediately after cryoablation in a single session.
methodsThis retrospective, single-center study included patients who underwent image-guided percutaneous cryoablation followed by immediate post-ablation core needle biopsy, performed at operator discretion, between December 2018 and April 2025. After active or passive thaw and probe removal, at least two 18-gauge core biopsy samples were obtained per lesion using a coaxial needle. Specimens were formalin-fixed and reviewed by pathology. Outcomes included specimen adequacy, histopathologic diagnosis, adverse events, imaging response, and tumor recurrence or seeding. Follow-up imaging and labs were performed at 3 and 6 or 9 months, then annually.
resultsTwenty-six solid enhancing renal masses (mean size 2.5 cm, range 1.4-4.7 cm) in 24 patients were included. All biopsy specimens were diagnostic with histologic diagnoses including renal cell carcinoma (RCC, n = 19), oncocytoma (n = 6), and metanephric adenoma (n = 1), with RCC subtypes including clear cell, papillary, chromophobe, sarcomatoid, and mixed histology. Complications were limited to the immediate post-procedural period, with no delayed adverse events or chronic sequelae. All lesions demonstrated complete radiographic response on 3-month follow-up imaging. There were no cases of tumor recurrence or seeding observed over a median follow-up of 1,415 days.
conclusionImmediate post-cryoablation renal mass biopsy is diagnostically reliable and may provide benefit in clinical practice.
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