CT-guided biopsy of small liver lesions : Visibility, artifacts, and corresponding diagnostic accuracy
| Autor: | Michael Forsting, Joerg Stattaus, T. Schroeder, Joerg Barkhausen, Gerald Antoch, Hilmar Kuehl, Susanne C. Ladd, Hideo A. Baba |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Target lesion medicine.medical_specialty Iohexol Radiography Medizin Contrast Media Radiography Interventional Sensitivity and Specificity Lesion Predictive Value of Tests Biopsy medicine Humans Radiology Nuclear Medicine and imaging False Negative Reactions Aged Retrospective Studies medicine.diagnostic_test business.industry Biopsy Needle Liver Neoplasms Ultrasound Visibility (geometry) Interventional radiology Middle Aged Predictive value of tests Radiographic Image Interpretation Computer-Assisted Female Radiology medicine.symptom Artifacts Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business |
| Popis: | Our study aimed to determine the visibility of small liver lesions during CT-guided biopsy and to assess the influence of lesion visibility on biopsy results. Fifty patients underwent CT-guided core biopsy of small focal liver lesions (maximum diameter, 3 cm); 38 biopsies were performed using noncontrast CT, and the remaining 12 were contrast-enhanced. Visibility of all lesions was graded on a 4-point-scale (0 = not visible, 1 = poorly visible, 2 = sufficiently visible, 3 = excellently visible) before and during biopsy (with the needle placed adjacent to and within the target lesion). Forty-three biopsies (86%) yielded diagnostic results, and seven biopsies were false-negative. In noncontrast biopsies, the rate of insufficiently visualized lesions (grades 0–1) increased significantly during the procedure, from 10.5% to 44.7%, due to needle artifacts. This resulted in more (17.6%) false-negative biopsy results compared to lesions with good visualization (4.8%), although this difference lacks statistical significance. Visualization impairment appeared more often with an intercostal or subcostal vs. an epigastric access and with a subcapsular vs. a central lesion location, respectively. With contrast-enhanced biopsy the visibility of hepatic lesions was only temporarily improved, with a risk of complete obscuration in the late phase. In conclusion, visibility of small liver lesions diminished significantly during CT-guided biopsy due to needle artifacts, with a fourfold increased rate of insufficiently visualized lesions and of false-negative histological results. Contrast enhancement did not reveal better results. |
| Databáze: | OpenAIRE |
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