Comparison of a coaxial versus non-coaxial liver biopsy technique in an oncological setting: diagnostic yield, complicat
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HEPATOBILIARY-PANCREAS
Comparison of a coaxial versus non-coaxial liver biopsy technique in an oncological setting: diagnostic yield, complications and seeding risk Nicos Fotiadis 1 & Katja N. De Paepe 1 & Lawrence Bonne 1 & Nasir Khan 1 & Angela Riddell 1 & Nicholas Turner 2 & Naureen Starling 2 & Marco Gerlinger 3 & Sheela Rao 2 & Ian Chau 2 & David Cunningham 2 & Dow-Mu Koh 1 Received: 19 March 2020 / Revised: 4 May 2020 / Accepted: 16 June 2020 # The Author(s) 2020
Abstract Objectives Percutaneous liver biopsy (PLB) poses specific challenges in oncological patients such as bleeding and tumour seeding. This study’s aim was to compare a coaxial (C-PLB) and non-coaxial (NC-PLB) biopsy technique in terms of diagnostic yield, safety and seeding risk of image-guided PLB techniques in an oncological setting. Methods Local research committee approval was obtained for this single-site retrospective study. Patients who underwent a PLB between November 2011 and December 2017 were consecutively included. Medical records were reviewed to determine diagnostic yield and complications. Follow-up imaging was re-reviewed for seeding, defined as visible tumour deposits along the PLB track. Mann-Whitney U and chi-squared tests were performed to investigate differences between biopsy techniques in sample number, complications and seeding rate. Results In total, 741 patients (62 ± 13 years, 378 women) underwent 932 PLB (C-PLB 72.9% (679/932); NC-PLB 27.1% (253/ 932)). More tissue cores (p < 0.001) were obtained with C-PLB (median 4 cores; range 1–12) compared with NC-PLB (2 cores; range 1–4) and diagnostic yield was similar for both techniques (C-PLB 92.6% (629/679); NC-PLB 92.5% (234/253); p = 0.940). Complication rate (9.3%; 87/932) using C-PLB (8.2% (56/679)) was lower compared with NC-PLB (12.3% (31/253); p = 0.024). Major complications were uncommon (C-PLB 2.7% (18/679); NC-PLB 2.8% (7/253)); bleeding developed in 1.2% (11/932; CPLB 1.2% (8/679); NC-PLB 1.2% (3/253)). Seeding was a rare event, occurring significantly less in C-PLB cases (C-PLB 1.3% (7/544); NC-PLB 3.1% (6/197); p = 0.021). Conclusions C-PLB allows for high diagnostic tissue yield with a lower complication and seeding rate than a NC-PLB and should be the preferred method in an oncological setting. Key Points • A coaxial percutaneous liver biopsy achieves a significant higher number of cores and fewer complications than a non-coaxial biopsy technique. • The risk of tumour seeding is very low and is significantly lower using the coaxial biopsy technique. • In this study, a larger number of cores (median = 4) could be safely acquired using the coaxial technique, providing sufficient material for advanced molecular analysis. Keywords Image-guided biopsy . Liver . Neoplasm seeding . Cancer
Dr Fotiadis and Dr De Paepe had equal contribution and are joint first authors. * Nicos Fotiadis [email protected] * Katja N. De Paepe [email protected]
1
Department of Radiology, The Royal Marsden NHS Foundation Trust, Downs Rd, Sutton, London SW2 5PT, UK
2
Dep
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