ECR 2012 / C-1540
Image guided liver biopsy: national audit of diagnostic accuracy and complications
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
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 the National Library of Guidelines,
identified research evidence and guidelines [1 – 5] from which audit standards (Table 6) were derived.
- Liver biopsy and histological assessment remains the gold standard for diagnosis in most pathologies although non-invasive tools,
imaging and blood tests are available.
- Core biopsy is accepted as of increased diagnostic value when compared to fine needle aspiration cytology.
A sample adequate for histological assessment and representative of the pathological process is required. The procedure must be tolerated well by the patient and complications must be minimised.
- There has been a shift from the traditional blind,
palpation technique to the utilisation of image-assisted or guided biopsy.
Ultrasound has become the modality of choice although CT and MR can be used to guide percutaneous biopsy.
- Multicentre data,
looking at current biopsy practice,
involving image guidance/assistance and core biopsy,
are relatively limited in the literature.