Image guided liver biopsy: national audit of diagnostic accuracy and complications

Congress:

ECR 2012

Poster Number:

C-1540

Type:

Scientific Paper

Keywords:

Abdomen, Ultrasound, Biopsy, Liver

Authors:

D. Christodoulou, J. Bajwa, K. Drinkwater, D. Lawrence, S. Barter, A. Nicholson, D. Howlett; London/UK

DOI:

10.1594/ecr2012/C-1540

DOI-Link:

https://dx.doi.org/10.1594/ecr2012/C-1540

Table 1: Responses to organisational questionnaire

Table 2: Staff undertaking liver biopsy

Table 3: Pre-procedural aspects of biopsy

Table 4: Technical aspects of biopsy by type of lesion on imaging

Purpose

We aimed to assess current techniques and practice of liver biopsy across the UK, to document rates of sample adequacy and diagnostic accuracy and compare with published literature, and to assess minor and major complications rates and compare with published literature. In addition, we aimed to attempt to identify statistically significant factors which may be associated with poor sample adequacy or accuracy, or increased rates of complications. A literature search of Medline (1950 onwards) and NHS evidence, including the Cochrane Library of Systematic Reviews and...

Methods and Materials

All UK radiology departments where liver biopsy was undertaken and with an audit lead registered with The Royal College of Radiologists were invited to participate in this retrospective audit (response rate = 87/210 departments). The first 50, consecutive patients who underwent image-guided or assisted biopsy from the beginning of 2008 were included for each department (3496 usable cases submitted). Inclusion criteria were patient records, radiology images/reports and histology available, and needle core biopsy only (percutaneous or transjugular). Fine needle aspiration cytology and surgical/laparoscopic biopsies were...

Results

Please refer to tables.

Conclusion

Advances in knowledge Data from this national study confirms the trend towards the use of image guidance, or assistance, in the performance of liver biopsies (Table 2). Most procedures are undertaken by radiologists using ultrasound as the imaging modality (Table 4). Focal lesions are more at risk of major complications post-biopsy (p = 0.0008). The overall mortality in the study was 0.11% with a diagnostic accuracy for focal lesions of 96.43%. We found no statistically significant link between INR/platelet counts and major bleeding complications. Implications...

References

REFERENCES [1] Rockey DC. Non-invasive assessment of liver fibrosis and portal hypertension with transient elastography. Gastroenterology 2008; 134:8-14. [2] Piccinino F, Sagnelli E, Pasquale E, Giusti G. Complications following percutaneous liver biopsy; a multicentre retrospective study on 68276 biopsies. J Hepatol 1986; 2:165-173. [3] McGill DB, Rakela J, Zinsmeister AR, OTT JB. A 21 year experience with major haemorrhage after percutaneous liver biopsy. Gastroenterology 1990; 99:1396-1409. [4] Neuberger J, Grant A, Day C, Saxseena S. Guidelines for the use of liver biopsy in clinical practice....

Personal Information

Acknowledgement : Nick Taylor, Medical Photographer, Eastbourne DGH