Needle-tract implantation in hepatocellular carcinoma: frequency and CT findings after biopsy with a 19.5-gauge automated biopsy gun

Abdom Imaging. May-Jun 2000;25(3):246-50. doi: 10.1007/s002610000025.


Background: Needle-tract implantation is an important complication of cutting biopsy of hepatocellular carcinoma (HCC). This study was performed to evaluate the frequency of needle-tract implantation after ultrasound (US)-guided percutaneous biopsy of HCC and to describe triple-phase helical computed tomographic (CT) findings of implanted nodules.

Methods: Between April 1994 and December 1997, 205 patients underwent US-guided percutaneous biopsy for HCC. Review of medical records and the pathology database disclosed seven patients who were found to have needle-tract implantation of HCC. Among these patients, five underwent triple-phase helical CT examination. We analyzed the frequency of needle-tract implantation and triple-phase helical CT findings of implanted nodules, with particular attention to the morphology and enhancement pattern.

Results: Seven of 205 patients (3.4%) had tumor implantation along the needle tract at histologic examination after surgical resection. Eight implanted nodules in five patients were found on triple-phase helical CT images (one nodule in three patients, two nodules in one patient, and three nodules in one patient). All implanted nodules has well-circumscribed margins and were ovoid or lobulated in contour. On triple-phase helical CT, six (75%) implanted nodules were isodense compared with abdominal wall muscle on all triple-phase CTs, and two (25%) nodules were hyperdense on hepatic arterial and portal venous phases and isodense on equilibrium phase.

Conclusions: The frequency of needle-tract implantation of HCC after percutaneous needle biopsy was higher than reported previously, and careful attention should be paid during interpretation of CT images in patients with a history of previous percutaneous biopsy.

Publication types

  • Comparative Study

MeSH terms

  • Abdominal Muscles
  • Adult
  • Aged
  • Biopsy, Needle / adverse effects*
  • Biopsy, Needle / instrumentation
  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / secondary
  • Humans
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / pathology
  • Male
  • Middle Aged
  • Muscle Neoplasms / diagnostic imaging*
  • Muscle Neoplasms / secondary
  • Neoplasm Seeding*
  • Skin Neoplasms / diagnostic imaging*
  • Skin Neoplasms / secondary
  • Thorax
  • Tomography, X-Ray Computed*