Image guided percutaneous renal biopsy, utilising either ultrasound or CT allows for an accurate, reliable method of acquiring renal tissue for histopathological assessment.

Biopsy make be of a native or transplant kidney. It is divided into two types:

  • non-focal or non-targeted
  • focal or targeted (i.e. directed at a lesion)

Either type may be performed as a CT guided biopsy or as an ultrasound guided biopsy 1. Recent description has been given of the use of 3D cone beam CT in assisting the biopsy of particularly challenging focal lesions 2.

This depends on both patient and operator factors, such as patient body habitus, ability to cooperate and operator experience. Transplant renal biopsy is usually undertaken with ultrasound guidance given its more superficial location in the pelvis.

An alternative option for percutaneous CT/US guidance is the transjugular renal biopsy.

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