MP28-13 DIAGNOSTIC YIELD AND ACCURACY OF OPTICAL COHERENCE TOMOGRAPHY (OCT) AND RENAL MASS BIOPSY FOR RENAL MASS DIFFERENTIATION

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging I1 Apr 2018MP28-13 DIAGNOSTIC YIELD AND ACCURACY OF OPTICAL COHERENCE TOMOGRAPHY (OCT) AND RENAL MASS BIOPSY FOR RENAL MASS DIFFERENTIATION Mara Buijs, Peter G Wagstaff, Patricia J Zondervan, C Dilara Savci-Heijink, Otto M van Delden, Ton G van Leeuwen, R Jeroen van Moorselaar, Jean JMCH de la Rosette, M. Pilar Laguna Pes, and Daniel M. de Bruin Mara BuijsMara Buijs More articles by this author , Peter G WagstaffPeter G Wagstaff More articles by this author , Patricia J ZondervanPatricia J Zondervan More articles by this author , C Dilara Savci-HeijinkC Dilara Savci-Heijink More articles by this author , Otto M van DeldenOtto M van Delden More articles by this author , Ton G van LeeuwenTon G van Leeuwen More articles by this author , R Jeroen van MoorselaarR Jeroen van Moorselaar More articles by this author , Jean JMCH de la RosetteJean JMCH de la Rosette More articles by this author , M. Pilar Laguna PesM. Pilar Laguna Pes More articles by this author , and Daniel M. de BruinDaniel M. de Bruin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.913AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Cross-sectional imaging lacks specificity in distinguishing benign or indolent small renal masses (SRMs) from renal cell carcinoma, leading to overtreatment. Additionally, renal mass biopsy (RMB) is hampered by high non-diagnostic rates. Optical coherence tomography (OCT) is a high resolution, real-time imaging modality, using backscattered near-infrared light for tissue differentiation. Percutaneous, needle-based OCT imaging and differentiation between benign and malignant RMs by quantitative parameters (attenuation-coefficient;μOCT) has proven to be safe and feasible. We prospectively assessed the diagnostic yield and accuracy of OCT and RMB and compared this to each other for the differentiation of RMs. METHODS Percutaneous, needle-based OCT was performed in consecutive patients with a solid enhancing renal mass. Final treatment pathology was used for correlation to μOCT and RMB. μOCT values for benign masses and oncocytoma vs RCC were compared using a Mann-Whitney test. Accuracy calculations were performed using ROC-curve and 2*2 tables for μOCT and RMB respectively. RESULTS Since October 2013, OCT was performed in 95 patients. The diagnostic yield of RMB and OCT was 79% and 99% respectively. The median μOCT of benign tumours (3.2mm-1, IQR 2.65-4.35) and oncocytoma (3.38mm-1, IQR 2.68-3.95) were significantly lower (P=0.0171, and P=0.0031 respectively) than the median μOCT of RCC (4.3mm-1, IQR 3.70-5.00) (Fig. 1A,C). In differentiating malignant from benign tumours, OCT shows a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 91%, 56%, 91%, and 56%, and respectively. The accuracy of OCT increases for the differentiation between RCC and oncocytoma, with a sensitivity, specificity, PPV and NPV of 92%, 67%, 95% and 55% respectively. RMB has a sensitivity, specificity, PPV and NPV of 100%, 89%, 99% and 100% respectively. CONCLUSIONS OCT accurately distinguishes malignant from benign renal tumours. Additionally, OCT has a higher diagnostic yield than RMBs, balanced by a lower specificity and NPV. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e361 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Mara Buijs More articles by this author Peter G Wagstaff More articles by this author Patricia J Zondervan More articles by this author C Dilara Savci-Heijink More articles by this author Otto M van Delden More articles by this author Ton G van Leeuwen More articles by this author R Jeroen van Moorselaar More articles by this author Jean JMCH de la Rosette More articles by this author M. Pilar Laguna Pes More articles by this author Daniel M. de Bruin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...