Ex vivo performance comparison of three percutaneous biopsy needle systems

  • Miltiadis KrokidisEmail author
  • Martin Hungerbühler
  • Ekkehard Hewer
  • Johannes Heverhagen
  • Hendrik von Tengg-Kobligk



The aim of this study is to identify the micro-mechanical characteristics that define biopsy performance in normal ex vivo animal organs.

Materials and methods

Three biopsy systems with differences of needle external diameter, tray height and effective tray length were assessed. Sampling was performed in porcine liver and kidneys with commercially labelled 14G, 16G and 18G, using 2-cm throw needle systems. Five samples were obtained per needle size and per organ, and the experiment was repeated twice for a total of 90 biopsy cores. Samples were analysed and compared in terms of macroscopic aspect, sample length, weight and tissue architecture.


The system with the longest effective needle tray (system A) has shown significant superiority (p < 0.001) versus the other systems regarding the mean weight of tissue obtained for all needle sizes. Furthermore, the 14G needle of system A has shown superiority regarding the number of portal spaces and the 16G regarding the length of kidney fragments obtained.


The outcomes obtained with the different biopsy systems were not equal. The micro-mechanical characteristic that appears to influence the quantity and quality of the obtained tissue is the effective needle tray length and not the needle external diameter or the needle tray height. This information should be taken into account in the future design of biopsy needle systems, particularly when potentially used in the assessment of biomarkers and the characterisation of tumour micro-environment.

Key Points

• The amount of obtained tissue mass is not the same among percutaneous biopsy needle systems.

• There are different micro-mechanical characteristics that condition the amount of obtained tissue.

• The micro-mechanical characteristic that offers more tissue mass for the same calibre is the effective length of the needle tray.


Biopsy Liver Kidney Tissue 



Analysis of variance


Deoxyribonucleic acid


Fine needle aspiration




Standard deviation


Statistical Package for the Social Sciences


United Kingdom


United States of America



We would like to thank Dr. Chara Tzavara for her contribution in the statistical analysis of the manuscript.


The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Prof. Hendrik von Tengg-Kobligk.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

Dr. Chara Tzavara kindly provided statistical advice for this manuscript.

Informed consent

Approval from the institutional animal care committee was not required because the study was performed ex vivo.

Ethical approval

Institutional Review Board approval was obtained.


• Prospective

• Experimental

• Performed at one institution


  1. 1.
    Gazelle GS, Haaga JR (1989) Guided percutaneous biopsy of intraabdominal lesions. AJR Am J Radiol 153:929–935Google Scholar
  2. 2.
    Marshall D, Laberge JM, Firetag B, Miller T, Kerlan RK (2013 Aug) The changing face of percutaneous image-guided biopsy: molecular profiling and genomic analysis in current practice. J Vasc Interv Radiol 24(8):1094–1103CrossRefGoogle Scholar
  3. 3.
    Gupta S, Wallace MJ, Cardella JF, Kundu S, Miller DL, Rose SC (2010) Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol 21:969–975Google Scholar
  4. 4.
    Stewart CJ, Coldewey J, Stewart IS (2002) Comparison of fine needle aspiration cytology and needle core biopsy in the diagnosis of radiologically detected abdominal lesions. J Clin Pathol 55:93–97CrossRefGoogle Scholar
  5. 5.
    Palmirotta R, Lovero D, Cafforio P et al (2018) Liquid biopsy of cancer: a multimodal diagnostic tool in clinical oncology. Ther Adv Med Oncol 10:1758835918794630CrossRefGoogle Scholar
  6. 6.
    Peters B, Mölne J, Hadimeri H, Hadimeri U, Stegmayr B (2017) Sixteen gauge biopsy needles are better and safer than 18 gauge in native and transplant kidney biopsies. Acta Radiol 58:240–248Google Scholar
  7. 7.
    Roth R, Parikh S, Makey D et al (2013) When size matters: diagnostic value of kidney biopsy according to the gauge of the biopsy needle. Am J Nephrol 37:249–254CrossRefGoogle Scholar

Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Department of RadiologyCambridge University Hospitals NHS Foundation TrustCambridgeUK
  2. 2.Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
  3. 3.Experimental Radiology, Department of BioMedical ResearchUniversity of BernBernSwitzerland
  4. 4.Institute of PathologyUniversity of BernBernSwitzerland

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