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dc.contributor.authorPaterson, Catherine
dc.contributor.authorGhaemi, Joseph
dc.contributor.authorAlashkham, Abduel
dc.contributor.authorBiyani, Chandra Shekhar
dc.contributor.authorCole, Bernadette
dc.contributor.authorBaker, Lee
dc.contributor.authorSzewczyk-Bieda, Magda
dc.contributor.authorNabi, Ghulam
dc.date.accessioned2018-06-07T15:40:46Z
dc.date.available2018-06-07T15:40:46Z
dc.date.issued2018-06-11
dc.identifier.citationPATERSON, C., GHAEMI, J., ALASHKHAM, A., BIYANI, C.S., COLES, B., BAKER, L., SZEWCZYK-BIEDA, M. and NABI, G. 2018. Diagnostic accuracy of image guided biopsies of small (<4cm) renal masses with implications for active surveillance: a systematic review. British journal of radiology [online], 91(1090), article ID 20170761. Available from: https://doi.org/10.1259/bjr.20170761en
dc.identifier.issn0007-1285en
dc.identifier.issn1748-880Xen
dc.identifier.urihttp://hdl.handle.net/10059/2950
dc.description.abstractObjectives: To determine the safety and diagnostic accuracy of renal tumour biopsies in a defined population of small renal masses only <4cm using 3x2 table, intention to diagnose approach. 3x2 table approach examines indeterminate results as a separate category rather than pushing these through traditional 2x2 table (four-cell matrix) approach. Methods and Materials: A highly sensitive search was performed in the Cochrane Library, Database of Abstracts of Reviews of Effects; MEDLINE and MEDLINE in Process, EMBASE and conference proceedings (1966 to 2016) for the acquisition of data on the diagnostic accuracy and complications of RTB in patients with SRM <4cm. Methodological quality and risk of bias was assessed using QUADAS-2. Test characteristics were calculated using conventional 2x2 contingency table analysis excluding non-diagnostic biopsies, and an intention-to-diagnose approach with a 3x2 table for pooled estimates of the sensitivity and specificity. Results: A total of 20 studies were included, with a total sample size of 974. The pooled estimates for sensitivity and specificity of RTB based upon univariate analysis using 2x2 table observed sensitivity .952 (CI 0.908 - 0.979) and specificity 0.824 (CI 0.566 - 0.962). Using the 3x2 table and intention-to-diagnose principle, sensitivity .947 (CI 0.925 - 0.965) and specificity 0.609 (CI 0.385 - 0.803) decreased. Conclusions: Renal tumour biopsy in small renal masses (<4cm) is associated with a high diagnostic sensitivity but poor specificity when non-diagnostic results are included by a 3×2 table for analysis (intention to diagnose approach). Risk of non-diagnostic results and poor quality of research need addressing through future studies, preferably by a well-designed prospective study appropriately powered for diagnostic accuracy using valid reference standards.en
dc.description.sponsorshipChief Scientist Office, Scotland, (Grant number CZG/2/343).en
dc.language.isoengen
dc.publisherBritish Institute of Radiologyen
dc.rightshttps://creativecommons.org/licenses/by/4.0en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectSmall renal massesen
dc.subjectRenal tumour biopsyen
dc.subjectAccuracyen
dc.subjectDiagnosisen
dc.subjectNeedle core biopsyen
dc.titleDiagnostic accuracy of image guided biopsies of small (<4cm) renal masses with implications for active surveillance: a systematic review.en
dc.typeJournal articlesen
dc.publisher.urihttps://doi.org/10.1259/bjr.20170761
dcterms.dateAccepted2018-06-06en
dcterms.publicationdate2018-08-31
refterms.accessExceptionNAen
refterms.dateDeposit2018-06-07en
refterms.dateEmbargoEnd2019-06-11en
refterms.dateFCA2019-06-11en
refterms.dateFCD2018-06-07en
refterms.dateFreeToDownload2019-06-11en
refterms.dateFreeToRead2019-06-11en
refterms.dateToSearch2019-06-11en
refterms.depositExceptionNAen
refterms.panelAen
refterms.technicalExceptionNAen
refterms.versionAMen
rioxxterms.publicationdate2018-06-11
rioxxterms.typeJournal Article/Reviewen
rioxxterms.versionAMen


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