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Transjugular liver biopsy in patients with diffuse liver disease:comparison of three cores with one or two cores for accurate histological interpretation

Cholangitas, E. and Quaglia, Alberto and Samonakis, D. and Mela, M. and Patch, D. and Dhillon, A.P. and Fanshawe, Thomas and Burroughs, A.K. (2007) Transjugular liver biopsy in patients with diffuse liver disease:comparison of three cores with one or two cores for accurate histological interpretation. Liver International, 27 (5). pp. 646-653.

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Abstract

Background: Transjugular liver biopsy (TJLB) can be performed to obtain more than two cores safely. This advantage has not been evaluated in terms of diagnostic accuracy or grading/staging evaluation. Aim: To evaluate whether three separate cores of TJLB provide more histological information compared with two or one cores. Methods: Twenty-three patients, who had three separate passes, with each core ≥7mm in length using a 19G Tru-cut needle, were evaluated. Each TJLB was blindly coded; the pathologist randomly assessed: (a) each core separately covering the other two, (b) two cores simultaneously covering the third and (c) the three cores together for diagnostic yield, inflammation and fibrosis. Results: The mean TJLB length was 32±5.5mm. In 12 one-core (52%) and 18 2-core (78%) assessments, diagnosis (mainly cirrhosis) was made correctly in each core. The within-patient standard deviations for one-core vs two-core assessment were similar for grading (0.42 and 0.47, respectively), but higher for staging (0.39 and 0.15, respectively). Staging was underestimated in assessing one-core and less for two cores compared to three cores. Conclusion: Three non-fragmented cores (each core ≥7mm in length) of TJLB can be considered a minimum requirement for histological assessment, giving better reproducibility in diagnosis as well as for inflammation and fibrosis.

Item Type: Article
Journal or Publication Title: Liver International
Uncontrolled Keywords: length ; liver biopsy ; percutaneous liver biopsy ; portal tract ; transjugular liver biopsy ; size of liver biopsy
Subjects: UNSPECIFIED
Departments: Faculty of Health and Medicine > Medicine
ID Code: 50580
Deposited By: ep_importer_pure
Deposited On: 28 Oct 2011 14:11
Refereed?: Yes
Published?: Published
Last Modified: 26 Jul 2012 19:41
Identification Number:
URI: http://eprints.lancs.ac.uk/id/eprint/50580

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