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Abdominal Radiology

, Volume 44, Issue 1, pp 310–317 | Cite as

Usefulness of real-time contrast-enhanced ultrasound guided coaxial needle biopsy for focal liver lesions

  • Xiaojing Cao
  • Zhenxing Liu
  • Xiang ZhouEmail author
  • Chengyun Geng
  • Qing Chang
  • Li Zhu
  • Wenqi Feng
  • Tianyu Xu
  • Yujing Xin
Article
  • 78 Downloads

Abstract

Purpose

To evaluate the utility of real-time contrast-enhanced ultrasound (CEUS)-guided coaxial needle biopsies for focal liver lesions (FLL) that were inconspicuous or could not be accurately identified the active site on B-mode ultrasound (US).

Materials and methods

This prospective study included 76 patients who had CEUS-guided coaxial needle biopsies for FLL between December 2015 and June 2017. We recorded characteristics of target lesions. We evaluated conspicuity of target lesions and accuracy of identifying the active site of target lesions on B-mode US and CEUS using a 5-point scale. Patients were divided into three groups, and analyzed according to body mass index (BMI). Based on the final diagnosis, the diagnostic performance was evaluated.

Results

The mean size and depth of target lesions were 41.5 ± 28.5 and 47.9 ± 18.9 mm on CEUS, respectively. In arterial phase, the enhanced pattern of target lesions varied. The conspicuity of target lesions and accuracy of identifying the active site of target lesions was significantly improved on CEUS compared to B-mode US (p < 0.05). The three BMI groups had significant differences in conspicuity of target lesions after using CEUS (p < 0.05). The high BMI group had a greater change in conspicuity of lesions compared to the normal BMI group or the low BMI group (p < 0.05). The sensitivity, specificity, and accuracy of this technique for the diagnosis of FLL were 92.8%, 100%, and 93.4%, respectively.

Conclusion

Real-time CEUS-guided coaxial needle biopsy can be very useful for FLL that are inconspicuous or cannot be accurately identified the active site on B-mode US.

Keywords

Focal liver lesion Contrast-enhanced ultrasound Coaxial needle biopsy 

Notes

Acknowledgments

We would like to thank all participants for their support in this study. No grant support needs to be reported.

Compliance with ethical standards

Funding

This work did not receive funding.

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration, and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants prior to enrollment in the study.

References

  1. 1.
    Sparchez Z, Radu P, Zaharia T, et al. (2010) Contrast enhanced ultrasound guidance: a new tool to improve accuracy in percutaneous biopsies. Med Ultrason 12(2):133–138Google Scholar
  2. 2.
    Caliskan KC, Cakmakci E, Celebi I, Basak M (2012) The importance of experience in percutaneous liver biopsies guided with ultrasonography: a lesion-focused approach. Acad Radiol 19(2):256–259CrossRefGoogle Scholar
  3. 3.
    Kim JW, Shin SS (2017) Ultrasound-guided percutaneous core needle biopsy of abdominal viscera: tips to ensure safe and effective biopsy. Korean J Radiol 18(2):309–322CrossRefGoogle Scholar
  4. 4.
    Sparchez Z, Radu P, Zaharia T, et al. (2011) Usefulness of contrast enhanced ultrasound guidance in percutaneous biopsies of liver tumors. J Gastrointest Liver Dis 20(2):191–196Google Scholar
  5. 5.
    Jung EM, Friedrich C, Hoffstetter P, et al. (2012) Volume navigation with contrast enhanced ultrasound and image fusion for percutaneous interventions: first results. PLoS ONE 7(3):e33956CrossRefGoogle Scholar
  6. 6.
    Lee MW (2014) Fusion imaging of real-time ultrasonography with CT or MRI for hepatic intervention. Ultrasonography 33(4):227–239CrossRefGoogle Scholar
  7. 7.
    Min JH, Lim HK, Lim S, et al. (2014) Radiofrequency ablation of very-early-stage hepatocellular carcinoma inconspicuous on fusion imaging with B-mode US: value of fusion imaging with contrast-enhanced US. Clin Mol Hepatol 20(1):61–70CrossRefGoogle Scholar
  8. 8.
    Minami T, Minami Y, Chishina H, et al. (2014) Combination guidance of contrast-enhanced US and fusion imaging in radiofrequency ablation for hepatocellular carcinoma with poor conspicuity on contrast-enhanced US/fusion imaging. Oncology 87(Suppl 1):55–62CrossRefGoogle Scholar
  9. 9.
    Park HS, Kim YJ, Yu MH, et al. (2015) Real-time contrast-enhanced sonographically guided biopsy or radiofrequency ablation of focal liver lesions using perflurobutane microbubbles (sonazoid): value of Kupffer-phase imaging. J Ultrasound Med 34(3):411–421CrossRefGoogle Scholar
  10. 10.
    Chung YE, Kim KW (2015) Contrast-enhanced ultrasonography: advance and current status in abdominal imaging. Ultrasonography 34(1):3–18CrossRefGoogle Scholar
  11. 11.
    Piscaglia F, Nolsøe C, Dietrich CA, et al. (2012) The EFSUMB guidelines and recommendations on the clinical practice of contrast enhanced ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall Med 33(1):33–59CrossRefGoogle Scholar
  12. 12.
    Lee MW, Kim YJ, Park SW, et al. (2010) Sequential changes in echogenicity and conspicuity of small hepatocellular carcinoma on gray scale sonography after transcatheter arterial chemoembolization. J Ultrasound Med 29(9):1305–1312CrossRefGoogle Scholar
  13. 13.
    Goto E, Masuzaki R, Tateishi R, et al. (2012) Value of post-vascular phase (Kupffer imaging) by contrast-enhanced ultrasonography using Sonazoid in the detection of hepatocellular carcinoma. J Gastroenterol 47(4):477–485CrossRefGoogle Scholar
  14. 14.
    Mishima M, Toh U, Iwakuma N, et al. (2016) Evaluation of contrast Sonazoid-enhanced ultrasonography for the detection of hepatic metastases in breast cancer. Breast Cancer 23(2):231–241CrossRefGoogle Scholar
  15. 15.
    Francica G, Meloni MF, de Sio I, et al. (2017) Biopsy of liver target lesions under contrast-enhanced ultrasound guidance: a multi-center study. Ultraschall Med.  https://doi.org/10.1055/s-0043-122496 Google Scholar
  16. 16.
    Kang HJ, Kim JH, Lee SM, et al. (2018) Additional value of contrast-enhanced ultrasonography for fusion-guided, percutaneous biopsies of focal liver lesions: prospective feasibility study. Abdom Radiol (NY).  https://doi.org/10.1007/s00261-018-1608-y Google Scholar
  17. 17.
    Sparchez Z, Radu P, Kacso G, et al. (2015) Prospective comparison between real time contrast enhanced and conventional ultrasound guidance in percutaneous biopsies of liver tumors. Med Ultrason 17(4):456–463Google Scholar
  18. 18.
    Yoon SH, Lee KH, Kim SY, et al. (2010) Real-time contrast-enhanced ultrasound-guided biopsy of focal hepatic lesions not localised on B-mode ultrasound. Eur Radiol 20(8):2047–2056CrossRefGoogle Scholar
  19. 19.
    Park HJ, Lee MW, Lee MH, et al. (2013) Fusion imaging-guided percutaneous biopsy of focal hepatic lesions with poor conspicuity on conventional sonography. J Ultrasound Med 32(9):1557–1564CrossRefGoogle Scholar
  20. 20.
    Kang TW, Lee MW, Song KD, et al. (2017) Added value of contrast-enhanced ultrasound on biopsies of focal hepatic lesions invisible on fusion imaging guidance. Korean J Radiol 18(1):152–161CrossRefGoogle Scholar
  21. 21.
    Partovi S, Lu Z, Kessner R, et al. (2017) Contrast enhanced ultrasound guided biopsies of liver lesions not visualized on standard B-mode ultrasound-preliminary experience. J Gastrointest Oncol 8(6):1056–1064CrossRefGoogle Scholar
  22. 22.
    Maturen KE, Nghiem HV, Marrero JA, et al. (2006) Lack of tumor seeding of hepatocellular carcinoma after percutaneous needle biopsy using coaxial cutting needle technique. Am J Roentgenol 187(5):1184–1187CrossRefGoogle Scholar
  23. 23.
    Schulze R, Seebacher G, Enderes B, et al. (2015) Complications in CT-guided, semi-automatic coaxial core biopsy of potentially malignant pulmonary lesions. Rofo 187(8):697–702CrossRefGoogle Scholar
  24. 24.
    Jandaghi AB, Habibzadeh H, Falahatkar S, et al. (2016) Transperineal prostate core needle biopsy: a comparison of coaxial versus noncoaxial method in a randomised trial. Cardiovasc Intervent Radiol 39(12):1736–1742CrossRefGoogle Scholar
  25. 25.
    Jandaghi AB, Lebady M, Zamani AA, et al. (2017) A randomised clinical trial to compare coaxial and noncoaxial techniques in percutaneous core needle biopsy of renal parenchyma. Cardiovasc Intervent Radiol 40(1):106–111CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Interventional Radiology, National Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
  2. 2.Department of UltrasoundXingtai City People’s HospitalXingtaiChina
  3. 3.Department of Ultrasound, National Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

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