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.
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.
Authors: Rüdiger Hoffmann; Christoph Thomas; Hansjörg Rempp; Diethard Schmidt; Philippe L Pereira; Claus D Claussen; Stephan Clasen Journal: Eur Radiol Date: 2011-09-30 Impact factor: 5.315
Authors: Joerg Stattaus; Stefan Maderwald; Hideo A Baba; Guido Gerken; Joerg Barkhausen; Michael Forsting; Mark E Ladd Journal: Eur Radiol Date: 2008-07-19 Impact factor: 5.315
Authors: F Cornelis; M Silk; H Schoder; H Takaki; J C Durack; J P Erinjeri; C T Sofocleous; R H Siegelbaum; M Maybody; S B Solomon Journal: Eur J Nucl Med Mol Imaging Date: 2014-08-09 Impact factor: 9.236
Authors: Rahul A Sheth; Ronald S Arellano; Raul N Uppot; Anthony E Samir; Lipika Goyal; Andrew X Zhu; Debra A Gervais; Umar Mahmood Journal: Radiology Date: 2014-10-10 Impact factor: 11.105
Authors: Ernst Michael Jung; Chris Friedrich; Patrick Hoffstetter; Lena Marie Dendl; Frank Klebl; Ayman Agha; Phillipp Wiggermann; Christian Stroszcynski; Andreas Georg Schreyer Journal: PLoS One Date: 2012-03-20 Impact factor: 3.240