Comparison of the diagnostic quality of aspiration and core-biopsy needles for transjugular liver biopsy

Dig Liver Dis. 2020 Dec;52(12):1473-1479. doi: 10.1016/j.dld.2020.08.028. Epub 2020 Sep 11.

Abstract

Background: Liver biopsy remains essential for the diagnostic work-up of patients with liver disease.

Aims: To evaluate aspiration vs. core-biopsy needles for transjugular liver biopsy (TJLB) in patients undergoing hepatic venous pressure gradient (HVPG) measurements.

Methods: 84 patients undergoing TJLB between 06/2017 and 12/2018 were prospectively included. Liver biopsy specimens were systematically evaluated for quantitative and qualitative criteria such as number of portal tracts, sample length and fragmentation.

Results: In direct comparison of paired TJLB specimens (n=35), core-biopsy samples were significantly longer (median 12 vs. 9mm, p=0.012), tended to contain more portal tracts (median 8 vs. 6, p=0.064) and were less fragmented (p<0.001), which resulted in better confidence for liver fibrosis assessment (p=0.035). However, a superior quality in terms of less fragmentation of core-biopsy specimens (p<0.05) was only confirmed in patients with HVPG ≥10mmHg or liver stiffness measurement >40kPa. In contrast, the aspiration needle provided significantly longer samples in patients with HVPG <10mmHg (median 21 vs. 12mm, p=0.007) or with liver stiffness measurement <20kPa (median 21 vs. 11mm, p=0.025).

Conclusion: In patients with HVPG ≥10mmHg, we recommend to performed TJLB using core-biopsy needles, while the aspiration needle provides high quality liver biopsy specimens in patients with HVPG <10mmHg.

Keywords: Cook needle; Menghini needle; TJLB; Tru-cut needle.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biopsy, Needle / methods*
  • Female
  • Humans
  • Jugular Veins*
  • Liver / blood supply
  • Liver / pathology*
  • Liver Cirrhosis / pathology
  • Liver Diseases / diagnosis*
  • Liver Diseases / pathology
  • Liver Transplantation
  • Male
  • Middle Aged
  • Portal Pressure*
  • Portal System / pathology