Haematocrit and haemoglobin decrease following image-guided percutaneous core needle biopsies
A Karatzas1, A Karamitros2, I Paraskevopoulos3
1Department of Radiology/Interventional Radiology, "Olympion" Hospital, Patras, Greece.
Insights
Image-guided percutaneous core needle biopsies (PCNBs) often cause a moderate drop in haematocrit (Ht) and haemoglobin (Hb) levels. This decrease is usually not clinically significant and does not indicate bleeding if no hemodynamic compromise is present.
Area of Science:
- Interventional Radiology
- Oncology
- Hematology
Background:
- Image-guided percutaneous core needle biopsies (PCNBs) are crucial for diagnosing various lesions.
- Monitoring changes in haematocrit (Ht) and haemoglobin (Hb) post-biopsy is important for patient safety.
Purpose of the Study:
- To assess the clinical significance of haematocrit (Ht) and haemoglobin (Hb) variations after image-guided PCNBs.
- To establish expected Ht and Hb level changes post-biopsy.
Main Methods:
- Retrospective analysis of 105 patients undergoing image-guided PCNBs.
- Comparison of pre- and post-procedural Ht and Hb values.
- Evaluation of complication rates and correlation with Ht/Hb changes.
Main Results:
- A significant mean decrease in Ht (38.75% to 36.49%) and Hb (12.79 g/dl to 12.03 g/dl) was observed post-PCNB (p<0.0001).
- 88.6% of patients showed decreased Ht, and 89.5% showed decreased Hb.
- Minor bleeding (3.8%) occurred without hemodynamic compromise, even with >4% Ht or ≥1.5 mg/dl Hb decrease in some cases.
Conclusions:
- A moderate post-PCNB decrease in Ht and Hb is expected.
- Such decreases are generally not indicative of significant bleeding unless accompanied by hemodynamic instability.
- Clinical monitoring should focus on signs of hemorrhage rather than solely on Ht/Hb values.
Aim:
To determine the clinical significance of variation in haematocrit (Ht) and haemoglobin (Hb) values before and after image-guided percutaneous core needle biopsies (PCNBs) and evaluate its clinical significance.
Materials And Methods:
This single-centre, retrospective study included all the patients who underwent image-guided PCNBs between November 2012 and September 2018. In total, 105 cases (56 male; 53.3%; mean age 72±8 years) were available for analysis. Biopsies included lesions of the liver, lung, kidney, bone, paravertebral and soft-tissue masses, peritoneal implantations, and retroperitoneal neoplasms. The study's primary outcome was to compare the pre- and post-procedural Ht and Hb values and to evaluate their clinical significance.
Results:
A significant decrease of the mean Hb and Ht values was detected post-biopsy (12.79±1.85 g/dl versus 12.03±1.72 g/dl and 38.75±4.93% versus 36.49±4.73%; p<0.0001). A decrease in the Ht and/or Hb level was noted in 93/105 (88.6%) and 94/105 (89.5%) of the patients; respectively. Four minor bleeding complications were noted (4/105; 3.8%), which resolved without any further treatment. An >4% decrease in Ht value was noted in 17/105 cases (16.2%) and an Hb decrease of ≥1.5 mg/dl was noted in 10/105 cases (9.5%), all without any haemodynamic compromise.
Conclusions:
A moderate post-PCNB decrease in Ht and Hb values compared to baseline should be expected, but should not raise concerns regarding an ongoing bleeding event, if not correlated with haemodynamic and clinical signs of haemorrhage.
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