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Safety of percutaneous, image-guided biopsy of hepatocellular carcinoma with and without concurrent ablation

  • Special Section: Cross sectional interventions
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To determine the prevalence of adverse events after image-guided biopsy of histologically proven hepatocellular carcinomas (HCC) using a standardized, indirect access, coaxial biopsy technique.

Methods

In this IRB-approved, HIPAA compliant, and retrospective study, we evaluated all consecutive adult patients from 2011 to 2016 who underwent image-guided biopsy of HCC with and without concurrent ablation. Tumor seeding was defined as any new lesion along the needle tract on subsequent imaging. Adverse events were graded using both the Clavien–Dindo Complication Classification system and the most recently proposed Society of Interventional Radiology (SIR) Adverse Event Classification System.

Results

A total of 383 patients underwent 398 biopsies (64 ± 11 years; 112 women, 271 men). Most patients (282; 71%) underwent concurrent ablation. Adverse events occurred after 18 biopsies (4.5%): 13 were Grade I (Clavien–Dindo) or minor (SIR) and included hematoma (7), hepatic vein thrombus (2), portal vein thrombus (2), moderate pleural effusion (1), and small pneumothorax (1). The remaining 5 (1.3%) adverse events were classified as Grade II–IIIa (Clavien–Dindo) or moderate (SIR) and included hematoma requiring blood products (n = 1), arrhythmia (n = 1), and symptomatic pleural effusions requiring treatment (n = 3). Baseline age, sex, cause of liver disease, HCC diameter, and HCC grade were not associated with adverse events. There were no tumor seeding events after a median follow-up of 611 days (interquartile range of 211–1104).

Conclusion

Percutaneous image-guided tissue sampling using a standardized, indirect access, coaxial technique can be performed safely with and without concurrent ablation by trained cross-sectional interventional radiologists at a tertiary liver transplant center.

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Authors and Affiliations

  1. Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Justin R. Tse & Luyao Shen

  2. Department of Radiology, University of California, San Francisco, 505 Parnassus Ave., San Francisco, CA, 94143, USA

    Kevin Terashima

  3. Department of Radiological Sciences, Los Angeles David Geffen School of Medicine, University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA

    Justin P. McWilliams, David S. K. Lu & Steven S. Raman

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  1. Justin R. Tse
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  2. Kevin Terashima
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Correspondence to Justin R. Tse.

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Tse, J.R., Terashima, K., Shen, L. et al. Safety of percutaneous, image-guided biopsy of hepatocellular carcinoma with and without concurrent ablation. Abdom Radiol 47, 2640–2646 (2022). https://doi.org/10.1007/s00261-022-03494-5

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  • DOI: https://doi.org/10.1007/s00261-022-03494-5

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