Diagnostic Interventions of Small < 2.5mm Focal Liver Lesions: US and CT-guided Biopsy

Atanas Dimitrov Hilendarov ,Prof. Kichka Georgieva Velkova, Prof. Antonia Nedeva

Purpose : The present study assess factors affecting the success of US and CT-guided liver biopsy of focal lesions on the basis of experience when cytopathologic examination results were available.Methods and Materials: 175 liver biopsies and punctures in 175 patients(120 male and 55 female) were performed under US or CT control. Lesions ranged in diameter from 9mm to 25 mm. We utilized US guidence in 103(66.02%) cases and CT guidence in 53(33.97%) cases. Ultrasound equipment supplied with 3.5 and 7 MHz linear and convex transducers, MDCT machine and biopsy needles were used. The on-site cytologic evaluation guided the radiologist to continue to another biopsy pass and avoid a nondiagnostic biopsy result. Results: During a 4-year period we performed FN liver biopsies or punctures in 175 patients (120 males and 55 females) with small (9-25mm) liver lesions. The CT guidance was utilized for biopsy of deep, small liver masses of ultrasonographically non visible and subdiaphragmatically located lesions. Interventional procedures under imaging control of small focal liver lesions had a sensitivity of 97.76 %, specificity of 80.48 % and accuracy of 93.71 %. The PPV (positive predictive value) is 94.24 % and the NPV (negative predictivе value) –91.66%. Conclusion: Interventional procedures under imaging (US and CT) control of the small focal liver lesions is a highly reliable, safe, inexpensive invasive procedure with great diagnostic value in suspected HCC less than 2 cm in diameter, liver metastases, as well as all benign tumors without typical findings on either dynamic multi-detector CT or CEUS.

https://doi.org/10.31871/WJRR.3.3.49