Aims and objectives
In the recently issued EFSUMB guidelines the use CEUS-guided biopsy is adviced in deep abdominal organs (mainly liver) to avoid necrotic areas or improve targeting of undetectable or not conspicuous lesion targets on B-mode US (1,2)
These recommendations were based on a limited number of papers using small,
old case series (3) or more recent single-center experiences (4,5) that do not accurately describe the role of the CEUS-guided bioptic maneuver in the routine clinical setting
The purpose of this retrospective study was characterize the prevalence...
Methods and materials
The Institutional Review Board-approved patient database was collected in each participating center during the period 2005-2016.
All patients who underwent CEUS-guided biopsy of FLL with fine or cutting needles at the participating centers were included (figures 1-2)
Informed consent was obtained from all of the patients
All participating centers were asked to gather data regarding
Rate of CEUS-guided procedures on FLL over the considered period of time
Indications to the CEUS-guided procedure
Biopsy Diagnostic yield
CEUS-guided biopsies were carried out in 103 patients (68 M / 35 F,
median age 69 years,
range 31-89) with 103 FLL (median size: 20 mm; range 8-55).
Twenty-six out of 103 patients (25.2%) had a previous non-diagnostic cyto-histological exam performed under non-enhanced US guidance
The rate of interventionalprocedures under CEUS guidance on FLL was 2.6% of 3818 biopsies on hepatic targets (range 0.8% - 7.7%) in the 6 participating Centers
Indications to CEUS-guided biopsy were
1) Detection of non-necrotic areas (40.9%) (VIDEO 1)
Our retrospective analysis provides a real snapshot of the use of CEUS as guiding system for liver biopsy on FLL in selected US interventional centers
Although the procedure is not frequently used (less than 3% of more than 3.000 biopies on FLL),
itrepresents a safe and effective tool to cope with challenging clinical scenarios:
poorly visualized or invisible lesions
sampling of non-necrotic areas in the target lesions
repeat biopsy after unsuccessful sampling performed using the standard unenhanced technique
Claudon et al.
Ultraschall in Med 2013
Dietrich et al .
Ultraschall in Med 2016
Schlottman et al.
Z Gastroenterol 2004
Yoon et al .
Eur Radiol 2010
Sparckez et al.
Med Ultrason 2015