[Liver biopsy under guidance of multislice computed tomography: comparison of 16G and 18G biopsy needles].

BACKGROUND

Percutaneous cutting needle biopsy of focal liver lesions under CT guidance has established itself as a standard method. The purpose of this study was to evaluate which diagnostic quality can be achieved under guidance of multislice CT (MSCT) and with the use of different needle sizes.

METHODS

The data of 163 MSCT-guided core biopsies of focal liver lesions were evaluated. A 16G biopsy needle was used in 121 cases and an 18G needle in 42 cases.

RESULTS

The sensitivity, specificity, and accuracy for all biopsies were 93.3, 100.0, and 94.5%. The corresponding values were 97.2, 100.0, and 97.5% for the 16G needle and 78.6, 100.0, and 85.7% for the 18G needle, respectively. A definite histological diagnosis could be obtained in 90.0% of the cases (16G 94.0%, 18G 75.8%). These differences were statistically highly significant. Bleeding complications were recognized in seven biopsies (4.3%). In one patient a fatal bleeding occurred after the biopsy. Median biopsy duration was 27 min.

CONCLUSIONS

Core biopsy under MSCT guidance is a fast and very accurate method to obtain a histological diagnosis in focal liver lesions. The usage of a 16G needle in comparison to an 18G needle yielded a significantly higher rate of correct results with regard to differentiation between benign and malignant disease as well as establishing a definite histological diagnosis. For an accurate diagnosis of liver lesions a 16G needle is recommended. After biopsy, the patients have to be closely monitored.