Research Article
Ultrasonografi kılavuzluğunda 18 ve 20 gauge kesici iğneler ile yapılan perkütan karaciğer kitle biyopsisi sonuçlarının karşılaştırılması
Abstract
Amaç: Çalışmamızda, ultrasonografi (US) kılavuzluğunda perkütan karaciğer kitle biyopsisinde kullanılan 18 Gauge (G) ve 20G kalınlıktaki kesici iğnelerin tanısal başarılarının ve etkinliklerinin karşılaştırılması amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya karaciğer kitlesi sebebiyle 18G (18G-Kİ) ve 20G kalınlıkta kesici iğnelerle (20G-Kİ) US kılavuzluğunda biyopsisi gerçekleştirilen 60 hasta dahil edildi. Biyopsi yapılan lezyonun histopatolojik değerlendirme sonuçları, takip, klinik ve görüntüleme bulgularıyla, tekrar biyopsi yapılan hastalarda biyopsi sonuçları incelenerek lezyonun kesin tanısı belirlendi. 18G-Kİ ve 20G-Kİ için duyarlılık, özgüllük, pozitif öngörü değeri, negatif öngörü değeri ve tanısal doğruluk oranları hesaplandı.
Bulgular: Değerlendirilen 60 karaciğer kitlesinin 54’ünün (%90) kesin tanısı malign iken altısının (%10) benign idi. 18G-Kİ’nin karaciğer kitle biyopsisi için duyarlılığı %90.7; özgüllüğü ve pozitif öngörü değeri %100.0; negatif öngörü değeri %75.0 ve tanısal doğruluk oranı %91.6 bulundu. 20G-Kİ’nin karaciğer kitle biyopsisi için duyarlılığı %87.0; özgüllüğü ve pozitif öngörü değeri %100.0; negatif öngörü değeri %66.7 ve tanısal doğruluk oranı %88.3 olarak hesaplandı. US kılavuzluğunda karaciğer kitlelerine yönelik yapılan kesici iğne biyopsisinde 18G-Kİ ve 20G-Kİ’nin kullanımıyla elde edilen sonuçlar arasında istatistiksel anlamlı fark bulunmadı (p=0.540).
Sonuç: Çalışmamızda karaciğer kitle lezyonlarının US kılavuzluğunda perkutan biyopsisinde; 18G-Kİ ve 20G-Kİ’nin benzer tanısal başarı ve etkinliğe sahip olduğu saptandı. İnce kalibrasyonu nedeniyle özellikle kanama bozukluğu varlığı gibi yüksek riskli hasta grubunda 20G-Kİ tercih edilebilir.
References
- Strassburg CP, Manns MP. Approaches to liver biopsy techniques--revisited. Semin Liver Dis 2006;26(4):318-27.
- Fulcher AS, Sterling RK. Hepatic neoplasms: computed tomography and magnetic resonance features. J Clin Gastroenterol 2002;34(4):463-71.
- Bonder A, Afdhal N. Evaluation of liver lesions. Clin Liver Dis 2012;16(2):271-83.
- Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Liver Biopsy. Hepatology 2009;49(3):1017-44.
- Gupta S. New techniques in image-guided percutaneous biopsy. Cardiovasc Intervent Radiol 2004;27(2):91-104.
- Al Knawy B, Shiffman M. Percutaneous liver biopsy in clinical practice. Liver Int 2007;27(9):1166-73.
- Zornoza J, Wallace S, Ordonez N, Lukeman J. Fine-needle aspiration biopsy of the liver. AJR Am J Roentgenol 1980;134(2):331-4.
- Hopper KD, Abendroth CS, Sturtz KW, Matthews YL, Shirk SJ, Stevens LA. Blinded comparison of biopsy needles and automated devices in vitro: 1. Biopsy of diffuse hepatic disease. AJR Am J Roentgenol 1993;161(6):1293-7.
- Mueller M, Kratzer W, Oeztuerk S, et al. Percutaneous ultrasonographically guided liver punctures: an analysis of 1961 patients over a period of ten years. BMC Gastroenterol 2012;12:173.
- Seçil M, Dicle O, Göktay AY, Yörükoğlu K, Güre A, Pirnar T. Comparison of biopsy devices: Sonographically guided percutaneous liver biopsies in rabbits. AJR Am J Roentgenol 1999;173(5):1203-5.
- Rossi P, Sileri P, Gentileschi P, et al. Percutaneous liver biopsy using an ultrasound-guided subcostal route. Dig Dis Sci 2001;46(1):128-32.
- Yu SC, Liew CT, Lau WY, Leung TW, Metreweli C. US-guided percutaneous biopsy of small (< or =1-cm) hepatic lesions. Radiology 2001;218(1):195-9.
- Appelbaum L, Kane RA, Kruskal JB, Romero J, Sonsa J. Focal hepatic lesions: US-guided biopsy--lessons from review of cytologic and pathologic examination results. Radiology 2009;250(2):453-8.
- Rivera-Sanfeliz G, Kinney TB, Rose SC, et al. Single-pass percutaneous liver biopsy for diffuse liver disease using an automated device: experience in 154 procedures. Cardiovasc Intervent Radiol 2005;28(5):584-8.
- Cakmakci E, Caliskan KC, Tabakci ON, Tahtabasi M, Karpat Z. Percutaneous liver biopsies guided with ultrasonography: A case series. Iran J Radiol 2013;10(3):182-4.
- Padia SA, Baker ME, Schaeffer CJ, et al. Safety and efficacy of sonographic-guided random real-time core needle biopsy of the liver. J Clin Ultrasound 2009;37(3):138-43.
- Caliskan KC, Cakmakci E, Celebi I, Basak M. The importance of experience in percutaneous liver biopsies guided with ultrasonography: A lesion-focused approach. Acad Radiol 2012;19(2):256-9.
- Anania G, Gigante E, Piciucchi M, et al. Liver biopsy: Analysis of results of two specialist teams. World J Gastrointest Pathophysiol 2014;5(2):114-9.
- Yu SC, Lau WY, Leung WT, Liew CT, Leung NW, Metreweli C. Percutaneous biopsy of small hepatic lesions using an 18 gauge automated needle. Br J Radiol 1998;71(846):621-4.
- Duysburgh I, Michielsen P, Fierens H, Van Marck E, Pelckmans P. Fine needle trucut biopsy of focal liver lesions: A new tecnique. Dig Dis Sci 1997;42(10):2077-81.
Comparison of the results of ultrasonography-guided percutaneous liver mass biopsy performed with 18 and 20 gauge needles
Abstract
Aim: To evaluate the role of using 18 Gauge (G) and 20G sharp needles in ultrasonography (US)-guided percutaneous liver mass biopsy regarding diagnostic success and efficacy is aimed.
Materials and Methods: Sixty patients who underwent US-guided liver mass biopsy using 18G and 20G cutting needles were included in the study. Definite diagnosis was established based on results of histopathological examinations of the biopsied lesions, follow-up clinical and imaging findings and for performed patients the results of repeated biopsy. In addition, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for 18G and 20G needles.
Results: Among 60 liver masses, definite diagnosis was malignant in 54 (90%) masses and benign in 6 (10%) masses. Sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 90.7%, 100.0%, 100.0%, 75.0%, and 91.6%, respectively, for the liver mass biopsies performed with 18G needles. These values were 87.0%, 100.0%, 100.0%, 66.7%, and 88.3%, respectively, for the liver mass biopsies performed with 20G needles. No significant difference was determined between the results found for the use of 18G needle and 20G needle in US-guided cutting needle biopsy performed in hepatic masses (p=0.540)
Conclusion: The present study demonstrated that 18G and 20G sharp needles had similar diagnostic success and efficacy in US-guided percutaneous biopsy of liver mass lesions. Owing to its fine calibration, 20G sharp needle can be preferred in high-risk patient groups, particularly in those with bleeding disorder.
References
- Strassburg CP, Manns MP. Approaches to liver biopsy techniques--revisited. Semin Liver Dis 2006;26(4):318-27.
- Fulcher AS, Sterling RK. Hepatic neoplasms: computed tomography and magnetic resonance features. J Clin Gastroenterol 2002;34(4):463-71.
- Bonder A, Afdhal N. Evaluation of liver lesions. Clin Liver Dis 2012;16(2):271-83.
- Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Liver Biopsy. Hepatology 2009;49(3):1017-44.
- Gupta S. New techniques in image-guided percutaneous biopsy. Cardiovasc Intervent Radiol 2004;27(2):91-104.
- Al Knawy B, Shiffman M. Percutaneous liver biopsy in clinical practice. Liver Int 2007;27(9):1166-73.
- Zornoza J, Wallace S, Ordonez N, Lukeman J. Fine-needle aspiration biopsy of the liver. AJR Am J Roentgenol 1980;134(2):331-4.
- Hopper KD, Abendroth CS, Sturtz KW, Matthews YL, Shirk SJ, Stevens LA. Blinded comparison of biopsy needles and automated devices in vitro: 1. Biopsy of diffuse hepatic disease. AJR Am J Roentgenol 1993;161(6):1293-7.
- Mueller M, Kratzer W, Oeztuerk S, et al. Percutaneous ultrasonographically guided liver punctures: an analysis of 1961 patients over a period of ten years. BMC Gastroenterol 2012;12:173.
- Seçil M, Dicle O, Göktay AY, Yörükoğlu K, Güre A, Pirnar T. Comparison of biopsy devices: Sonographically guided percutaneous liver biopsies in rabbits. AJR Am J Roentgenol 1999;173(5):1203-5.
- Rossi P, Sileri P, Gentileschi P, et al. Percutaneous liver biopsy using an ultrasound-guided subcostal route. Dig Dis Sci 2001;46(1):128-32.
- Yu SC, Liew CT, Lau WY, Leung TW, Metreweli C. US-guided percutaneous biopsy of small (< or =1-cm) hepatic lesions. Radiology 2001;218(1):195-9.
- Appelbaum L, Kane RA, Kruskal JB, Romero J, Sonsa J. Focal hepatic lesions: US-guided biopsy--lessons from review of cytologic and pathologic examination results. Radiology 2009;250(2):453-8.
- Rivera-Sanfeliz G, Kinney TB, Rose SC, et al. Single-pass percutaneous liver biopsy for diffuse liver disease using an automated device: experience in 154 procedures. Cardiovasc Intervent Radiol 2005;28(5):584-8.
- Cakmakci E, Caliskan KC, Tabakci ON, Tahtabasi M, Karpat Z. Percutaneous liver biopsies guided with ultrasonography: A case series. Iran J Radiol 2013;10(3):182-4.
- Padia SA, Baker ME, Schaeffer CJ, et al. Safety and efficacy of sonographic-guided random real-time core needle biopsy of the liver. J Clin Ultrasound 2009;37(3):138-43.
- Caliskan KC, Cakmakci E, Celebi I, Basak M. The importance of experience in percutaneous liver biopsies guided with ultrasonography: A lesion-focused approach. Acad Radiol 2012;19(2):256-9.
- Anania G, Gigante E, Piciucchi M, et al. Liver biopsy: Analysis of results of two specialist teams. World J Gastrointest Pathophysiol 2014;5(2):114-9.
- Yu SC, Lau WY, Leung WT, Liew CT, Leung NW, Metreweli C. Percutaneous biopsy of small hepatic lesions using an 18 gauge automated needle. Br J Radiol 1998;71(846):621-4.
- Duysburgh I, Michielsen P, Fierens H, Van Marck E, Pelckmans P. Fine needle trucut biopsy of focal liver lesions: A new tecnique. Dig Dis Sci 1997;42(10):2077-81.
There are 20 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | March 14, 2019 |
| Submission Date | January 18, 2018 |
| Published in Issue | Year 2019Volume: 58 Issue: 1 |
