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제목	Real-Time Bedside Evaluation of Kidney Biopsy Adequacy Using Built-in Smartphone Macro Photography
저자	Minji Kim
출판정보	2025; 2025(1):
키워드	kidney biopsy, biopsy adequacy, pathology, smartphone
초록	Assessing biopsy adequacy is essential for a successful kidney biopsy procedure. With advancements in smartphone technology, smartphone-based evaluation is increasingly utilized in pathology. Recent improvements in smartphone cameras have enabled high-resolution macro imaging through built-in camera modules. We hypothesized that nephrologists could visually determine specimen adequacy with the assistance of a modern smartphone’s built-in macro camera. A prospective cohort study was conducted with consecutive adult patients who underwent ultrasound-guided native kidney biopsies performed by two nephrologists between February 2025 and March 2025. Macro photography of each biopsy core was manually captured using the built-in macro photography mode of Galaxy S25 Ultra (Samsung) immediately after each procedure. Adequacy determinations made via smartphone macro imaging were compared to those made by a pathology technician using standard light microscopy (Olympus, BX40). Statistical agreement between the two methods was assessed using Cohen’s kappa coefficient. Among 12 kidney biopsy patients, a total of 43 kidney cores were obtained. 31 (72.1%) cores were considered adequate by both smartphone macro imaging and standard microscopy, while 10 (23.3%) cores were deemed inadequate by both methods. One sample (2.3%) was classified as adequate by smartphone macro imaging but inadequate under microscopy, and another sample (2.3%) was considered inadequate via smartphone macro imaging but adequate under microscopy. The smartphone macro photography-based assessment had a positive adequacy agreement rate of 96.9% and a negative adequacy agreement of 90.9%, with an overall agreement rate of 95.4% (Cohen’s kappa: 0.878). The mean number of glomeruli included in final pathology results was 20.4±9.4, and all biopsies led to definite pathologic diagnosis. Bedside evaluation of ultrasound-guided kidney biopsy samples using smartphone-based macro photography demonstrated excellent agreement with standard microscopic assessment, offering a cost-effective, accessible, and time-efficient alternative for evaluating kidney biopsy adequacy. This method has the potential to reduce nondiagnostic results in real-world clinical practice.
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