Utility of image-guided percutaneous needle biopsy in focal liver lesions

To determine the utility of percutaneous needle biopsy guided by imaging methods (ultrasound and computed tomography) in the study of focal liver lesions. We present a series of 106 patients with focal liver lesions in whom ultrasound-guide (n=53) or commuted tomography-guided (n=53) percutaneous biopsy was performed. Needle size ranged between 21 (0.8 mm) and 14 G (2mm). The maximum diameter of the lesions was 5.3 cm. The overall diagnostic accuracy of the technique was 87.1%. The positive predictive value in the detection of malignant disease was 98.7%, while the negative predictive value was only 50%. Sensitivity was 88.5% and specificity 96%. There was only one major complication (0.9%). The comparative analysis of the two groups according to the method for guidance indicated the superiority of ultrasonography; however, the mean diameter of the lesions was greater than for computed tomography-guided biopsy. We propose image-guided percutaneous needle biopsy as an effective method for the diagnosis of focal liver lesions that, moreover, is associated with a low rate of morbidity. The better results observed for ultrasound in our series may have been due, to the larger diameters of the lesions and additional factors such as their location. (Author) 14 refs