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Small (1.5 cm or less) liver metastases: US-guided biopsy
W D Middleton1, S K Hiskes, S A Teefey
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Radiology
|December 11, 1997
Summary
Ultrasound-guided biopsy is effective for diagnosing small hepatic metastases (≤1.5 cm). This technique successfully obtained adequate specimens in 96% of patients, confirming the diagnosis of metastatic disease.
Area of Science:
- Radiology
- Oncology
- Gastroenterology
Background:
- Hepatic metastases often present as small lesions (≤1.5 cm).
- Accurate diagnosis of small hepatic metastases is crucial for treatment planning.
- Ultrasound (US) guidance offers a minimally invasive approach for tissue sampling.
Purpose of the Study:
- To evaluate the techniques and success rates of US-guided biopsy for small hepatic metastases (≤1.5 cm).
- To assess the feasibility of obtaining adequate diagnostic specimens from small liver lesions.
Main Methods:
- Retrospective review of 29 patients with 30 hepatic masses (≤1.5 cm) sampled via US-guided biopsy.
- Free-hand biopsy technique utilizing various needles (22-gauge aspirating needle common) and phased-array sector transducers.
- Assessment of lesion characteristics, procedural parameters, and diagnostic yield.
Main Results:
- Mean lesion diameter was 1.3 cm; mean depth was 5 cm.
- Adequate specimens for histologic diagnosis were obtained in 93% of lesions and 96% of patients.
- Cytologic analysis was performed on 20 lesions with an average of 2.7 passes per lesion.
Conclusions:
- Ultrasound-guided biopsy is an effective method for diagnosing small hepatic metastases.
- The free-hand technique allows for successful tissue acquisition from small liver lesions.
- US guidance provides a high diagnostic yield for metastatic disease in small liver lesions.