Aims and objectives
Computed tomography (CT) and magnetic resonance (MR) studies of the abdomen are two of the most commonly used imaging modalities to classify hepatic lesions.
Skillful radiological interpretation can assist clinicians in determining appropriate management,
including when to proceed with CT-guided biopsy.
Furthermore,
biopsies of malignant lesions provide histological grade,
tumor receptor and/or mutation status,
which is of great value for oncologists in optimizing the treatment plan.
The aim of this study was to assess the accuracy of radiological interpretation of liver lesions,
by comparing pathology...
Methods and materials
A retrospective analysis of liver lesions that were biopsied at our institution was conducted.
Patients included in the study underwent CT-guided biopsy of a liver lesion between December 2012and December 2014,
inclusive.
Patients included in the study were subjected to a thorough review of their charts,
including any prior imaging studies available,
and correlation to biopsy pathology results.
For those patients with prior imaging,
they were divided into categories based on the type(s) of imaging obtained prior to biopsy.
Subsequently,the radiological impression of the likelyetiology...
Results
Two-hundred and forty-two (242) patients underwent liver biopsy during the study time period.
Of these,
64 had no prior imaging available at our institution.
Many of thesepatients likely had outside imaging performed,
and were referred for liver biopsy.
A majority (45.3%) were found to have hepatitis.
23.4% had malignancy lesions,
such as metastases,
hepatocellular carcinoma (HCC) and lymphoma.
These patients were excluded from further data analysis.
The remaining patients (180) have had at least one imaging study of the liver performed at our institution,
prior...
Conclusion
Concordance of radiological imaging interpretation and pathology findings was 100% in cases where the patient underwent prior ultrasound,
PET scan,
contrast-enhanced CT,
MRI or a combination of CT and MRI.
Overall,
63 of 180 benign hepatic lesions were clearly identified as such on imaging alone,
meaning that 35% of biopsies could have been avoided.
Imaging interpretation thereby aids in assistingclinicians in avoiding exposing patients to the risks inherent with direct tissue sampling.
In cases of CT without contrast,
20% of malignant lesions were incorrectly classified...
References
Pirovano G,
Vanzulli A,
Marti-Bonmati L et al.
Evaluation of the Accuracy of Gadobenate Dimeglumine-Enhanced MR Imaging in the Detection and Characterization of Focal Liver Lesions.
Am J Roentgenol. 2000;175(4):1111–1120.
Rummeny E,
Weissleder R,
Stark DD et al.
Primary liver tumors: diagnosis by MR imaging.Am J Roentgenol.1989;152:63-67.
Semelka RC,
Martin,
DR,
Balci C et al.
Focal liver lesions: Comparison of dual-phase CT and multisequence multiplanar MR imaging including dynamic gadolinium enhancement.
J Magn Reson Im. 2001;13(3):397-401.
Taouli B,
Vilgrain V,
Dumont E et al.
Evaluation...