Risk of needle tract seeding after coaxial ultrasound-guided percutaneous biopsy for primary and metastatic tumors of th
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INTERVENTIONAL RADIOLOGY
Risk of needle tract seeding after coaxial ultrasound‑guided percutaneous biopsy for primary and metastatic tumors of the liver: report of a single institution Dagmar Schaffler‑Schaden1 · Theresa Birsak2 · Ramona Zintl3 · Barbara Lorber4 · Gottfried Schaffler2
© The Author(s) 2019
Abstract Purpose The objective of this study was to determine the incidence of needle track seeding after ultrasound-guided percutaneous biopsy of indeterminate liver lesions with a coaxial biopsy system without any other additional intervention or ablation therapy. Methods We identified 172 patients in a retrospective cohort study who underwent ultrasound-guided biopsy due to a liver mass in our institution between 2007 and 2016. The same coaxial biopsy system was used in all patients, no consecutive ablation was performed. Results None of the finally included 131 patients developed neoplastic seeding. There was one major complication (0.76%), the rest of the complications were minor (3.8%) and did not require further intervention. Conclusion Needle track seeding is a rare delayed complication after percutaneous liver biopsy. Coaxial liver biopsy is a safe method to obtain multiple samples with a single punch in patients with primary or metastatic liver lesions. Keywords Coaxial biopsy · Needle tract seeding · Liver biopsy · Ultrasound-guided biopsy
Background There is increasing demand for pathologic specimens in modern medicine that is partly being driven by personalized medicine. Ultrasound-guided percutaneous needle biopsy is still the method of choice for the assessment of focal liver lesions with suspected malignancy due to several advantages as lack of radiation exposure, low cost, and direct visualization of the needle position in real time [1]. Complications of percutaneous liver biopsy * Dagmar Schaffler‑Schaden [email protected] 1
Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria
2
Department of Radiology and Nuclear Medicine, Hospital of St. John of God, Kajetanerplatz 1, 5020 Salzburg, Austria
3
Faculty of Natural Sciences, University of Salzburg, Hellbrunner Strasse 34, 5020 Salzburg, Austria
4
Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria
are uncommon, but may encompass bleeding, hematoma, infection, pneumothorax, or perforation [2]. A safe ultrasound-guided biopsy requires a normal coagulation status, an accessible target, and a cooperative patient [3]. One rare, but serious complication after percutaneous liver biopsy is needle tract seeding, which is a concern particularly in liver transplant recipients. The insertion of the needle and biopsy of a malignant lesion can cause spreading of tumor cells along the needle track. Usually, seeding after liver biopsy is defined as nodular neoplastic tissue along the needle tract outside the liver capsule appearing in the peritoneal cavity, the subcutaneous tissue, the abdominal muscles, or the skin. The
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