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Updated: Aug 7, 2026
Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
Liver biopsy methods for pediatric oncology patients
1Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN 38105-2794, USA. fred.hoffer@stjude.org
Background:
Liver biopsy is a high-risk procedure in oncology patients, and optimal methods for children have not been established.
Objective:
To assess the effectiveness and safety of two methods of performing liver biopsy in pediatric oncology patients.
Materials And Methods:
Between May 1997 and July 1999, 51 liver biopsies (22 percutaneous and 29 transjugular) were performed. The 22 percutaneous biopsies (13 focal hepatic lesions and 9 general liver biopsies) were performed under sonographic guidance; 21 used a spring-loaded needle (usually 18 G). In 21 patients, a coaxial sheath was used to inject a slurry of microfibrillar collagen into the needle track. The 29 transjugular general liver biopsies were performed with a 19-G spring-loaded needle, under sonographic and fluoroscopic guidance. The transjugular technique was used for children with thrombocytopenia, coagulopathy, ascites, or recent bone-marrow transplantation.
Results:
All biopsies yielded sufficient tissue for diagnostic studies. Bleeding occurred after 3 of 21 percutaneous biopsies, despite coaxial track embolization. No bleeding or other major complication occurred after transjugular biopsy.
Conclusion:
Coaxial percutaneous biopsy with track embolization was effective, but was not complication-free; it should be reserved for focal lesions or for patients at low risk of bleeding. Transjugular liver biopsy is safe and effective for use in high-risk pediatric oncology patients.
