Effect of needle gauge and lobe laterality on parenchymal liver biopsy outcome: a retrospective analysis

Abdom Imaging. 2015 Jun;40(5):1223-9. doi: 10.1007/s00261-014-0290-y.


Purpose: To analyze the effect of lobe selection, needle gauge, and number of passes on procedure outcomes in terms of specimen length and post-procedure complications.

Methods: In this HIPAA-compliant, IRB-approved retrospective study, the data from 771 ultrasound-guided adult parenchymal liver biopsies were analyzed. Post-procedure complications were assigned a 3-point rating scale. Associations between specimen length and post-procedure complications with lobe laterality, needle gauge, and number of passes were analyzed. Multivariate logistic regression models were used to analyze the likelihood for achieving a specimen length of at least 2 cm.

Results: Post-procedure complications were not associated with lobe laterality, needle gauge, and number of passes (p > 0.3). Specimen length was associated with the number of passes dichotomized at the study mean (p = 0.007), but not with lobe laterality or needle gauge (p > 0.2). After adjusting for lobe laterality and needle gauge, procedures with 1 or 2 passes were associated with a higher likelihood of obtaining a 2 cm or longer specimen (OR 2.469; CI 1.08-5.63, p = 0.0315) than procedures with 3 or more passes, possibly due to poorer sample quality. After adjusting for lobe laterality, an 18-gauge needle was associated with higher odds of a biopsy procedure with 1 or 2 passes (OR 3.665; CI 1.93-6.95, p < 0.0001) than a 20-gauge needle.

Conclusions: Lobe laterality was not associated with specimen length or post-procedure complications. An 18-gauge needle compared to a 20-gauge needle could reduce the need for a procedure with more than 2 passes. There was no difference in post-procedure complications between the two needle sizes.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle / instrumentation*
  • Biopsy, Needle / methods*
  • Female
  • Humans
  • Image-Guided Biopsy
  • Liver / pathology*
  • Male
  • Middle Aged
  • Needles
  • Patient Selection
  • Retrospective Studies
  • Ultrasonography, Interventional
  • Young Adult