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
Complication rates
Results
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)
2)...
Conclusion
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
References
1.
M.
Claudon et al.
Ultraschall in Med 2013
2.
C.F.
Dietrich et al .
Ultraschall in Med 2016
3.
K.
Schlottman et al.
Z Gastroenterol 2004
4.
S.H.
Yoon et al .
Eur Radiol 2010
5.
Z.
Sparckez et al.
Med Ultrason 2015