J Korean Soc Med Ultrasound.  2000 Mar;19(1):9-14.

Automatic Ultrasound-Guided Percutaneous Gun Biopsy of the Malignant Hepatic Tumors: Analysis of Diagnostic Accuracy and Causes of the Inconclusive Results

• Kim SK
• Kim SH
• Lim HK
• Lee WJ
• Cho JM
• Kim YH
• Yi CA
• Choi MH

Abstract

PURPOSE
To evaluate the accuracy of histopathologic diagnoses according to the types of tumor, its size and the number of adequately obtained specimens and causes of the inconclusive results of automatic ultrasound(US)-guided gun biopsy of malignant hepatic tumors.
MATERIALS AND METHODS
From Sep. 1994 to Dec. 1997, we performed 378 US-guided biopsies of 368 malignant hepatic tumors in 363 patients. All biopsies were performed using a 17.5 G automated biopsy gun with the free-hand technique. We retrospectively analyzed the diagnostic accuracy with regards to the types of tumor, its size, number of adequately obtained specimens and compared it with the final diagnosis. The causes of failure were also analyzed.
RESULTS
The overall accuracy in histopathologic diagnoses was 92.9% (351/378) and the diagnostic accuracy with regard to the types of tumor and its size was not statistically significant (p>0.05). The diagnostic accuracy ac-cording to the number of adequately obtained specimens were as follows: 72.7% (8/11) in one, 92.9% (125/135) in t, 94.1% (192/203) in three, and 90% (26/29) in more than four. There was no significant statistical differ-ence between each group except in the group obtaining one specimen. The causes of the inconclusive results were due to extensive tumor necrosis (n=13), difficult location of the tumor (n=8), isoechogenicity of the tumor (n=2), technical failure (n=3), and its small size (<1 cm) (n=1). Significant complications were found in 11 pa-tients (2.9%): bleeding in four and needle-tract seeding in seven.
CONCLUSION
In automatic US-guided gun biopsy, there was no difference in the diagnostic accuracy between the types of tumor and its size. Differences in diagnostic accuracy was non-existent when more than two specimens were obtained adequately. The important causes of the inconclusive results were due to extensive tumor necro-sis and difficult tumor location.

MeSH Terms

Biopsy*
Diagnosis
Hemorrhage
Humans
Necrosis
Retrospective Studies