James H Boyum1, Thomas D Atwell2, Darci J Wall2, Aaron S Mansfield3, Sarah E Kerr4, Tina M Gunderson5, Kandelaria M Rumilla4, Adam J Weisbrod2, A Nicholas Kurup2. 1. Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. Boyum.james@mayo.edu. 2. Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. 3. Department of Medical Oncology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. 4. Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. 5. Department of Clinical Statistics, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Abstract
PURPOSE: To analyze a large volume of image-guided liver mass biopsies to assess for an increased incidence of major hemorrhage after aggressive liver mass sampling, and to determine if coaxial technique reduces major hemorrhage rate. METHODS: Patients who underwent image-guided liver mass biopsy over a 15-year period (December 7, 2001-September 22, 2016) were retrospectively identified. An aggressive biopsy was defined as a biopsy event in which ≥ 4 core needle passes were performed. Association of major hemorrhage after aggressive liver mass biopsy and other potential risk factors of interest were assessed using logistic regression analysis. For the subset of aggressive biopsies, Fisher's exact test was used to compare the incidence of major hemorrhage using coaxial versus noncoaxial techniques. RESULTS: Aggressive biopsies constituted 11.6% of biopsy events (N =579/5011). The incidence of major hemorrhage with <4 passes was 0.4% (N =18/4432) and with ≥4 passes 1.2% (N =6/579). In univariable models, aggressive biopsy was significantly associated with major hemorrhage (OR 3.0, 95% CI 1.16-6.92, p =0.025). After adjusting for gender and platelet count, the association was not significant at the p =0.05 level (OR 2.58, 95% CI 0.927-6.24, p =0.067). The rate of major hemorrhage in the coaxial biopsy technique group was 1.4% (N =3/209) compared to 1.1% (N =4/370) in the noncoaxial biopsy technique group, which was not a significant difference (p =0.707). CONCLUSIONS: Although aggressive image-guided liver mass biopsies had an increased incidence of major hemorrhage, the overall risk of bleeding remained low. The benefit of such biopsies will almost certainly outweigh the risk in most patients.
PURPOSE: To analyze a large volume of image-guided liver mass biopsies to assess for an increased incidence of major hemorrhage after aggressive liver mass sampling, and to determine if coaxial technique reduces major hemorrhage rate. METHODS:Patients who underwent image-guided liver mass biopsy over a 15-year period (December 7, 2001-September 22, 2016) were retrospectively identified. An aggressive biopsy was defined as a biopsy event in which ≥ 4 core needle passes were performed. Association of major hemorrhage after aggressive liver mass biopsy and other potential risk factors of interest were assessed using logistic regression analysis. For the subset of aggressive biopsies, Fisher's exact test was used to compare the incidence of major hemorrhage using coaxial versus noncoaxial techniques. RESULTS: Aggressive biopsies constituted 11.6% of biopsy events (N =579/5011). The incidence of major hemorrhage with <4 passes was 0.4% (N =18/4432) and with ≥4 passes 1.2% (N =6/579). In univariable models, aggressive biopsy was significantly associated with major hemorrhage (OR 3.0, 95% CI 1.16-6.92, p =0.025). After adjusting for gender and platelet count, the association was not significant at the p =0.05 level (OR 2.58, 95% CI 0.927-6.24, p =0.067). The rate of major hemorrhage in the coaxial biopsy technique group was 1.4% (N =3/209) compared to 1.1% (N =4/370) in the noncoaxial biopsy technique group, which was not a significant difference (p =0.707). CONCLUSIONS: Although aggressive image-guided liver mass biopsies had an increased incidence of major hemorrhage, the overall risk of bleeding remained low. The benefit of such biopsies will almost certainly outweigh the risk in most patients.
Authors: Nikolaus A Handke; Dennis C Koch; Eugen Muschler; Daniel Thomas; Julian A Luetkens; Ulrike I Attenberger; Daniel Kuetting; Claus C Pieper; Kai Wilhelm Journal: Sci Rep Date: 2021-12-30 Impact factor: 4.379
Authors: Kelley Weinfurtner; Joshua Cho; Daniel Ackerman; James X Chen; Abashai Woodard; Wuyan Li; David Ostrowski; Michael C Soulen; Mandeep Dagli; Susan Shamimi-Noori; Jeffrey Mondschein; Deepak Sudheendra; S William Stavropoulos; Shilpa Reddy; Jonas Redmond; Tamim Khaddash; Darshana Jhala; Evan S Siegelman; Emma E Furth; Stephen J Hunt; Gregory J Nadolski; David E Kaplan; Terence P F Gade Journal: Sci Rep Date: 2021-11-23 Impact factor: 4.996