[Liver biopsy under guidance of multislice computed tomography: comparison of 16G and 18G biopsy needles].
ABSTRACT Percutaneous cutting needle biopsy of focal liver lesions under CT guidance has established itself as a standard method. The purpose of this study was to evaluate which diagnostic quality can be achieved under guidance of multislice CT (MSCT) and with the use of different needle sizes.
The data of 163 MSCT-guided core biopsies of focal liver lesions were evaluated. A 16G biopsy needle was used in 121 cases and an 18G needle in 42 cases.
The sensitivity, specificity, and accuracy for all biopsies were 93.3, 100.0, and 94.5%. The corresponding values were 97.2, 100.0, and 97.5% for the 16G needle and 78.6, 100.0, and 85.7% for the 18G needle, respectively. A definite histological diagnosis could be obtained in 90.0% of the cases (16G 94.0%, 18G 75.8%). These differences were statistically highly significant. Bleeding complications were recognized in seven biopsies (4.3%). In one patient a fatal bleeding occurred after the biopsy. Median biopsy duration was 27 min.
Core biopsy under MSCT guidance is a fast and very accurate method to obtain a histological diagnosis in focal liver lesions. The usage of a 16G needle in comparison to an 18G needle yielded a significantly higher rate of correct results with regard to differentiation between benign and malignant disease as well as establishing a definite histological diagnosis. For an accurate diagnosis of liver lesions a 16G needle is recommended. After biopsy, the patients have to be closely monitored.
- [Show abstract] [Hide abstract]
ABSTRACT: The purpose of this study was to retrospectively evaluate the effect of various factors, including overall patient size, weight, and individual lesion characteristics, on the radiation dose and procedure time required to successfully perform computed tomography (CT)-guided liver lesion biopsies. This Institutional-Review-Board-approved study included 209 patients (average age, 59 years; range, 19-86 years; 105 males, 104 females) who underwent CT-guided liver lesion biopsy on a four-slice multidetector row CT scanner (LightSpeed Qx/i; GE Healthcare, Milwaukee, WI). Medical records and images were retrospectively reviewed to obtain the following data: (a) patient weight, (b) patient size, (c) lesion volume, (d) lesion depth, (e) CT dose index (CTDI) and effective radiation dose, and (f) procedure time. Statistical analysis was performed with multiple linear regression to assess the effect of various parameters on radiation dose and procedure time. CTDI was significantly correlated with patient weight (P<.01), size (P=.03), and lesion volume (P<.01). The total effective radiation dose was significantly correlated with patient size (P<.01) and lesion depth (P<.01). Total procedure time was significantly correlated with lesion volume (P<.01) and depth (P<.01). There was a positive correlation between procedure time and effective radiation dose (r(2)=.57). In the current study, CT-guided liver lesion biopsy patient radiation dose was associated with both overall patient-specific features (weight and size) and specific lesion characteristics; however, the procedure duration was determined by lesion characteristics (lesion volume and depth) alone.Clinical imaging 07/2010; 34(4):263-8. · 0.73 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The purpose of this study was to assess a new open system with a field-strength of 1.0 T for the feasibility of liver biopsy using the freehand technique with fast continuous imaging. Fifty patients with focal liver lesions measuring 5 to 30 mm in diameter were included in the study. Guidance and monitoring was performed using a 1.0-T open magnetic resonance (MR) scanner (Panorama HFO; Philips Healthcare, Best, The Netherlands). With fast continuous imaging using a T1-weighted (T1W) gradient echo (GRE) sequence after administration of gadolinium (Gd)-EOB-DTPA, the needle was placed into the lesion. An interface for interactive dynamic viewing in two perpendicular planes prevented needle deviations T2-weighted turbo spin echo (TSE) fat-suppressed sequence was added to rule out postinterventional hematoma or biloma. All lesions were visible on the interventional images. Biopsy was technically successful, and solid specimens were obtained in all cases. Forty-six patients showed a histopathologic pattern other than native liver tissue, thus confirming correct position of the needle. Time between determination of the lesion and performance of the control scan was on average 18 min. No major complications were recorded. MR guidance with the new 1-T open system must be considered an attractive alternative for liver punction. An interface for dynamic imaging of needle guidance and T1W-GRE imaging with administration of Gd-EOB-DTPA for contrast enhancement allows the pinpoint puncture of liver lesions.CardioVascular and Interventional Radiology 03/2010; 34(1):188-92. · 2.09 Impact Factor
Chapter: Ways to the Target[Show abstract] [Hide abstract]
ABSTRACT: Cross-sectional imaging modalities such as ultrasound, computed tomography (CT), and magnetic resonance (MR) imaging are well-accepted guiding tools for interventional biopsies and therapies (Gupta and Madoff 2007). Especially CT combined with fluoroscopy is able to offer fast and safe ways to nearly any target in the human body, incorporating the major advantage of panoramic views compared with ultrasound, and therefore represents very often the guiding modality of choice (Rogalla and Juran 2004). Even targets in bones and air-containing structures (e.g., lungs) can be addressed very easily and successfully with CT guidance. In contrast, MR imaging seems to be more complex and time-consuming and therefore is usually reserved for interventional procedures in very tricky areas with the necessity of high soft-tissue contrast and in situations where CT is contraindicated (Gupta 2004). The accuracy of the puncture and the complication rates depend on the target size and site, traversing and surrounding anatomical structures, the number of biopsies, the material and puncture technique selected, and patient’s cooperation (Gupta and Madoff 2007).12/2008: pages 55-68;