CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy
- University Hospital Essen, University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology (Germany)
- University Hospital Essen, University of Duisburg-Essen, Department of Pathology (Germany)
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.
- OSTI ID:
- 21090827
- Journal Information:
- Cardiovascular and Interventional Radiology, Vol. 30, 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); ISSN 0174-1551
- Country of Publication:
- United States
- Language:
- English
Similar Records
Utility of CT-guided abdominal aspiration procedures
Percutaneous CT-Guided Biopsy of the Lung: Comparison Between Aspiration and Automated Cutting Needles Using a Coaxial Technique