Ultrasonography-directed native renal biopsy: comparison of an automated biopsy device with a needle system

The authors compared the performance of an automated biopsy device with a large-bore cutting needle system in ultrasonography-guided native renal biopsy. They retrospectively analysed 52 biopsy specimens from 50 adults with diffuse renal parenchymal disease. Twenty-six consecutive biopsy samples had been obtained manually with a 14-gauge needle (Tru-Cut, Travenol Laboratories, Deerfield, Ill.); a second set of 26 samples had been obtained with a biopsy gun (Bard Biopty, Radiplast, Uppsala, Sweden) fitted with a 14-gauge needle of similar design. The systems were compared in terms of the specimens obtained (the adequacy and the quality of tissue, the number of intact glomeruli and the presence of artifacts) and the incidence of biopsy-related complications. Biopsy specimens obtained with the biopsy gun were judged qualitatively as well as quantitatively superior; they contained an average of 17.6 intact glomeruli, whereas only 11.5 intact glomeruli were retrieved with the needle system. Although the incidence of minor complications was lower after biopsy with the automated gun than after use of the needle system (8% and 15% respectively), two major complications were observed after gun biopsy and none after needle biopsy. The results reported here indicate that for native renal biopsy the Biopty gun delivers a higher-quality tissue core with a lower frequency of minor complications, but not of major complications, than the Tru-Cut needle system.