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Title: CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy

Abstract

Purpose. Our study aimed to determine the visibility of small liver lesions during CT-guided biopsy and to assess the influence of lesion visibility on biopsy results. Material and Methods. Fifty patients underwent CT-guided core biopsy of small focal liver lesions (maximum diameter, 3 cm); 38 biopsies were performed using noncontrast CT, and the remaining 12 were contrast-enhanced. Visibility of all lesions was graded on a 4-point-scale (0 = not visible, 1 = poorly visible, 2 = sufficiently visible, 3 = excellently visible) before and during biopsy (with the needle placed adjacent to and within the target lesion). Results. Forty-three biopsies (86%) yielded diagnostic results, and seven biopsies were false-negative. In noncontrast biopsies, the rate of insufficiently visualized lesions (grades 0-1) increased significantly during the procedure, from 10.5% to 44.7%, due to needle artifacts. This resulted in more (17.6%) false-negative biopsy results compared to lesions with good visualization (4.8%), although this difference lacks statistical significance. Visualization impairment appeared more often with an intercostal or subcostal vs. an epigastric access and with a subcapsular vs. a central lesion location, respectively. With contrast-enhanced biopsy the visibility of hepatic lesions was only temporarily improved, with a risk of complete obscuration in the late phase.more » Conclusion. In conclusion, visibility of small liver lesions diminished significantly during CT-guided biopsy due to needle artifacts, with a fourfold increased rate of insufficiently visualized lesions and of false-negative histological results. Contrast enhancement did not reveal better results.« less

Authors:
; ; ; ;  [1];  [2]; ;  [1]
  1. University Hospital Essen, University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology (Germany)
  2. University Hospital Essen, University of Duisburg-Essen, Department of Pathology (Germany)
Publication Date:
OSTI Identifier:
21090827
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 30; Journal Issue: 5; Other Information: DOI: 10.1007/s00270-007-9023-8; Copyright (c) 2007 Springer Science+Business Media, LLC; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; BIOPSY; HAZARDS; LIVER; VISIBILITY

Citation Formats

Stattaus, Joerg, E-mail: joerg.stattaus@uni-due.de, Kuehl, Hilmar, Ladd, Susanne, Schroeder, Tobias, Antoch, Gerald, Baba, Hideo A., Barkhausen, Joerg, and Forsting, Michael. CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy. United States: N. p., 2007. Web. doi:10.1007/S00270-007-9023-8.
Stattaus, Joerg, E-mail: joerg.stattaus@uni-due.de, Kuehl, Hilmar, Ladd, Susanne, Schroeder, Tobias, Antoch, Gerald, Baba, Hideo A., Barkhausen, Joerg, & Forsting, Michael. CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy. United States. doi:10.1007/S00270-007-9023-8.
Stattaus, Joerg, E-mail: joerg.stattaus@uni-due.de, Kuehl, Hilmar, Ladd, Susanne, Schroeder, Tobias, Antoch, Gerald, Baba, Hideo A., Barkhausen, Joerg, and Forsting, Michael. Sat . "CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy". United States. doi:10.1007/S00270-007-9023-8.
@article{osti_21090827,
title = {CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy},
author = {Stattaus, Joerg, E-mail: joerg.stattaus@uni-due.de and Kuehl, Hilmar and Ladd, Susanne and Schroeder, Tobias and Antoch, Gerald and Baba, Hideo A. and Barkhausen, Joerg and Forsting, Michael},
abstractNote = {Purpose. Our study aimed to determine the visibility of small liver lesions during CT-guided biopsy and to assess the influence of lesion visibility on biopsy results. Material and Methods. Fifty patients underwent CT-guided core biopsy of small focal liver lesions (maximum diameter, 3 cm); 38 biopsies were performed using noncontrast CT, and the remaining 12 were contrast-enhanced. Visibility of all lesions was graded on a 4-point-scale (0 = not visible, 1 = poorly visible, 2 = sufficiently visible, 3 = excellently visible) before and during biopsy (with the needle placed adjacent to and within the target lesion). Results. Forty-three biopsies (86%) yielded diagnostic results, and seven biopsies were false-negative. In noncontrast biopsies, the rate of insufficiently visualized lesions (grades 0-1) increased significantly during the procedure, from 10.5% to 44.7%, due to needle artifacts. This resulted in more (17.6%) false-negative biopsy results compared to lesions with good visualization (4.8%), although this difference lacks statistical significance. Visualization impairment appeared more often with an intercostal or subcostal vs. an epigastric access and with a subcapsular vs. a central lesion location, respectively. With contrast-enhanced biopsy the visibility of hepatic lesions was only temporarily improved, with a risk of complete obscuration in the late phase. Conclusion. In conclusion, visibility of small liver lesions diminished significantly during CT-guided biopsy due to needle artifacts, with a fourfold increased rate of insufficiently visualized lesions and of false-negative histological results. Contrast enhancement did not reveal better results.},
doi = {10.1007/S00270-007-9023-8},
journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 5,
volume = 30,
place = {United States},
year = {2007},
month = {9}
}