Safety and efficacy of sonographic-guided random real-time core needle biopsy of the liver
Article first published online: 30 JAN 2009
Copyright © 2009 Wiley Periodicals, Inc.
Journal of Clinical Ultrasound
Volume 37, Issue 3, pages 138–143, March/April 2009
How to Cite
Padia, S. A., Baker, M. E., Schaeffer, C. J., Remer, E. M., Obuchowski, N. A., Winans, C. and Herts, B. R. (2009), Safety and efficacy of sonographic-guided random real-time core needle biopsy of the liver. J. Clin. Ultrasound, 37: 138–143. doi: 10.1002/jcu.20553
- Issue published online: 4 MAR 2009
- Article first published online: 30 JAN 2009
- Manuscript Accepted: 26 NOV 2008
- Manuscript Received: 22 MAY 2008
- sonographic guidance;
- interventional sonogram
To determine the safety and efficacy of real-time, sonographic-guided, random percutaneous needle biopsy of the liver in a tertiary medical center.
From an IRB-approved biopsy database, all patients who had random liver biopsy performed over a 24-month period were selected. In 350 patients, 539 random percutaneous needle biopsies of the liver were performed under real-time sonographic visualization. The following were recorded from the electronic medical record: patient demographics, indication for biopsy procedure; radiologist's name; needle type and gauge and number of passes; use and amount of IV sedation or anesthesia; adequacy of the specimen; and complications following the procedure.
Of 539 biopsies, 378 (70%) biopsy procedures were performed on liver transplant recipients. Of the biopsy procedures in nontransplant patients, 81/161 (50%) concurrently underwent biopsy of a focal liver mass. An 18-gauge automated core biopsy needle was used in 536/539 (99%). Median number of passes per biopsy procedure was 1 (mean, 1.7; range, 1–6). Sedation using midazolam and fentanyl was used in 483/539 (90%). There were only 8 inadequate specimens (1.5%, [2.3, upper 95% confidence limit, fully described in Statistical Analysis]). Complications were identified in 11/539 biopsy procedures (2.0%, [2.6, upper 95% confidence limit]): 5 with severe postprocedural pain, 3 with symptomatic hemorrhage, 2 with infection, and 1 with a rash. There were no sedation-related complications and no deaths related to the procedure.
Real-time, sonographic-guided, random core-needle liver biopsy is a safe and highly effective procedure. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009