Comparison of the diagnostic quality of aspiration and core-biopsy needles for transjugular liver biopsy.
Cook needle
Menghini needle
TJLB
Tru-cut needle
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
24
03
2020
revised:
14
08
2020
accepted:
19
08
2020
pubmed:
16
9
2020
medline:
2
9
2021
entrez:
15
9
2020
Statut:
ppublish
Résumé
Liver biopsy remains essential for the diagnostic work-up of patients with liver disease. To evaluate aspiration vs. core-biopsy needles for transjugular liver biopsy (TJLB) in patients undergoing hepatic venous pressure gradient (HVPG) measurements. 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. 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). 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.
Sections du résumé
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.
Identifiants
pubmed: 32928675
pii: S1590-8658(20)30447-3
doi: 10.1016/j.dld.2020.08.028
pii:
doi:
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1473-1479Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors have nothing to disclose regarding the work under consideration for publication. The following authors disclose conflicts of interests outside the submitted work: J.S. received grant support from Eli Lilly and Company, and Gilead. B.Si. received travel support from AbbVie. B.Sch. received travel support from AbbVie and Gilead. P.S. received travel support from Boehringer Ingelheim and Gilead as well as speaker fees from Boehringer Ingelheim. M.P. received travel support from Bayer and served as advisory board member for Bayer, Bristol-Myers Squibb, and Eisai. M.T. received travel support from AbbVie, Falk, Gilead and Intercept, grant support from Albireo, Cymabay, Falk, Gilead, Intercept, MSD, and Takeda, honoraria for consulting from AbbVie, BiomX, Boehringer Ingelheim, Falk, Gilead, Genfit, Intercept, MSD, Novartis, Phenex and Regulus, as well as speaker fees from Falk, Gilead, Intercept and MSD. M.M. received travel support from AbbVie, Bristol-Myers Squibb, and Gilead, and served as a speaker and/or consultant and/or advisory board member for AbbVie, Bristol-Myers Squibb, Gilead, and W. L. Gore & Associates. T.R. received travel support from Boehringer Ingelheim, Gilead, and Roche, served as a speaker and/or consultant and/or advisory board member for AbbVie, Bayer, Boehringer Ingelheim, Gilead, Intercept, MSD, Roche, Siemens, and W. L. Gore & Associates, and received grants/research support from AbbVie, Boehringer Ingelheim, Gilead, MSD, Philips, and W. L. Gore & Associates. G.S., K.W., R.P., A.F.S., T.M. and A.B. have nothing to disclose.