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CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy

  • Clinical Investigation
  • Published:
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Abstract

Purpose

Our study aimed to determine the visibility of small liver lesions during CT-guided biopsy and to assess the influence of lesion visibility on biopsy results.

Material and Methods

Fifty patients underwent CT-guided core biopsy of small focal liver lesions (maximum diameter, 3 cm); 38 biopsies were performed using noncontrast CT, and the remaining 12 were contrast-enhanced. Visibility of all lesions was graded on a 4-point-scale (0 = not visible, 1 = poorly visible, 2 = sufficiently visible, 3 = excellently visible) before and during biopsy (with the needle placed adjacent to and within the target lesion).

Results

Forty-three biopsies (86%) yielded diagnostic results, and seven biopsies were false-negative. In noncontrast biopsies, the rate of insufficiently visualized lesions (grades 0–1) increased significantly during the procedure, from 10.5% to 44.7%, due to needle artifacts. This resulted in more (17.6%) false-negative biopsy results compared to lesions with good visualization (4.8%), although this difference lacks statistical significance. Visualization impairment appeared more often with an intercostal or subcostal vs. an epigastric access and with a subcapsular vs. a central lesion location, respectively. With contrast-enhanced biopsy the visibility of hepatic lesions was only temporarily improved, with a risk of complete obscuration in the late phase.

Conclusion

In conclusion, visibility of small liver lesions diminished significantly during CT-guided biopsy due to needle artifacts, with a fourfold increased rate of insufficiently visualized lesions and of false-negative histological results. Contrast enhancement did not reveal better results.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

    Joerg Stattaus, Hilmar Kuehl, Susanne Ladd, Tobias Schroeder, Gerald Antoch, Joerg Barkhausen & Michael Forsting

  2. Department of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

    Hideo A. Baba

  3. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, 45122, Essen, Germany

    Joerg Stattaus

Authors
  1. Joerg Stattaus
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  2. Hilmar Kuehl
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  3. Susanne Ladd
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  4. Tobias Schroeder
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  5. Gerald Antoch
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  6. Hideo A. Baba
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  7. Joerg Barkhausen
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  8. Michael Forsting
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Correspondence to Joerg Stattaus.

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Stattaus, J., Kuehl, H., Ladd, S. et al. CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy. Cardiovasc Intervent Radiol 30, 928–935 (2007). https://doi.org/10.1007/s00270-007-9023-8

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  • DOI: https://doi.org/10.1007/s00270-007-9023-8

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