Safety of percutaneous biopsy of hepatocellular carcinoma with an 18 gauge automated needle.
ABSTRACT Accurate histological diagnosis and subtyping of hepatocellular carcinoma (hepatoma) is likely to be enhanced if a large biopsy tissue specimen is made available to the pathologist. However biopsy of this tumour can be dangerous, especially if the liver is cirrhotic and the lesion is superficial. This study evaluates the safety of an 18 gauge spring loaded side-cutting needle in the percutaneous biopsy of hepatoma in cirrhotic patients under ultrasonographic (US) guidance. Particular attention was paid to establishing the necessary length of needle track through interposing liver parenchyma to be certain of maximum safety.
One hundred and thirty-nine consecutive biopsy procedures were performed on 129 hepatomas which belonged to 113 men and 12 women of average age 57 +/- 15 years old (median 60, range 8 months-88 years). Ninety-six (69.1%) of these biopsies were performed in cirrhotic livers. The length of biopsy needle track traversing interposing liver parenchyma was less than 1 cm in two cases, 1 cm in 41 cases, between 1 and 2 cm in 46 cases and > 2 cm in 50 cases. The mean tumour size was 7.2 +/- 4.5 cm (median 6.8 cm, range 0.7-25 cm). The average number of needle pass in each biopsy was 2.1 +/- 0.8 times (median 2, range 1-5).
One hundred and twenty-six (90.6%) of the biopsy procedures were diagnostic of hepatoma. There were two cases of post-biopsy bleeding, both occurred in procedures with an interposing liver parenchymal track less than 1 cm in length.
The biopsy technique described was found to be safe for diagnosing hepatoma in patients with or without liver cirrhosis provided that the length of interposing liver parenchymal track is not < 1 cm.
- SourceAvailable from: ajronline.orgAmerican Journal of Roentgenology 02/1990; 154(1):1-10. · 2.90 Impact Factor
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ABSTRACT: In 170 cases of hepatocellular carcinoma, ultrasound showed a high sensitivity in identifying focal liver lesions. Fine needle aspiration biopsy guided by ultrasound yielded a pathological diagnosis in the majority of cases. The advantages of this technique, its high diagnostic yield and low cost, render the older technique of blind percutaneous biopsy using a coarse needle obsolete. Laparoscopy retains its essential role in selected cases. Complementary use of fine needle aspiration biopsy under ultrasound guidance and laparoscopy assures the highest rate of diagnostic accuracy in hepatocellular carcinoma. We confirm the poor sensitivity of alpha fetoprotein.Gut 12/1990; 31(11):1303-5. · 10.73 Impact Factor
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ABSTRACT: Ultrasonically guided fine-needle biopsy of focal liver lesions was performed in 126 patients to obtain a definitive diagnosis. Percutaneous target puncture and tissue aspiration were guided by a real-time linear-array probe with a central canal for needle insertion. The procedure is simple and rapidly performed; a correct cytological diagnosis was established in 94% of the punctured masses. No adverse reactions of clinical significance were observed. Fine-needle biopsy with ultrasound guidance by real-time scanning may be the procedure of choice to obtain a tissue diagnosis in patients with hepatic masses.British Journal of Radiology 11/1982; 55(658):717-23. · 1.22 Impact Factor