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

Kim, S. H.; Lim, Hyo Keun; Lee, Won Jae; Cho, J. M.; Jang, Hyuk Jai

doi:10.1007/s002610000025

Cited by 126 publications

(93 citation statements)

References 4 publications

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“…However, the accuracy of needle biopsy is limited ( 22 ) and becomes increasingly challenging technically with smaller tumors. In addition, percutaneous biopsy of hepatic lesions introduces risks of bleeding, hepatic decompensation, tumor peritoneal seeding, and even death (23)(24)(25)(26)(27). More recent work by Choi et al ( 28 ), who assessed the accuracy of MR imaging for HCC detection in explanted livers and also utilized updated MR imaging systems, reports similar results to our current study for smaller ( , 2 cm) tumors.…”

Section: Gastrointestinal Imaging: Mr Detection Of Hepatocellular Carsupporting

confidence: 79%

Hepatocellular Carcinoma Lesion Characterization: Single-Institution Clinical Performance Review of Multiphase Gadolinium-enhanced MR Imaging—Comparison to Prior Same-Center Results after MR Systems Improvements

Becker-Weidman¹,

Kalb²,

Sharma³

et al. 2011

Radiology

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Purpose:To measure diagnostic performance in the detection of hepatocellular carcinoma (HCC) by using the most recent technology and multiphase gadolinium-enhanced magnetic resonance (MR) imaging and to compare with earlier results at the same institution. Materials and Methods:This retrospective study was institutional review board approved and HIPAA compliant. Informed consent was obtained. Between January 2008 and April 2010, 101 patients underwent liver transplantation and pretransplantation abdominal MR imaging within 90 days. Prospective image interpretations from the clinical record were reviewed for documentation of HCC, including size, number, and location. Liver explant histologic examination provided the reference standard for lesion analysis and was performed in axial gross slices in conjunction with the MR imaging report for direct comparison. Tumors were categorized according to size ( Ն 2 cm or , 2 cm), and MR imaging detection sensitivity, specifi city, predictive values, and accuracy were calculated according to category. The Fisher exact test was used to compare results from this study against prior reported results. Results:Thirty-fi ve (34.7%) of 101 patients had HCC at explant analysis. Patient-based analysis of all lesions showed a sensitivity and specifi city of 97.1% (34 of 35) and 100% (66 of 66), respectively. For lesions 2 cm or larger, MR imaging had a sensitivity and specifi city of 100% (23 of 23) and 100% (78 of 78), respectively. For lesions smaller than 2 cm, MR imaging had a sensitivity and specifi city of 82.6% (19 of 23) and 100% (78 of 78), respectively. Lesion-based sensitivity for all tumors was 91.4% (53 of 58) in the current study, compared with 77.8% in 2007 ( P = .07). For lesions smaller than 2 cm, the sensitivity was 87.5% (28 of 32) in the current study, compared with 55.6% previously ( P = .02). Conclusion:MR imaging remains a highly accurate diagnostic method for the preoperative evaluation of HCC, and detection of small ( , 2 cm) tumors has been signifi cantly improved compared with that of earlier studies.q RSNA, 20111 From the Departments of Radiology

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Section: Gastrointestinal Imaging: Mr Detection Of Hepatocellular Carsupporting

confidence: 79%

Hepatocellular Carcinoma Lesion Characterization: Single-Institution Clinical Performance Review of Multiphase Gadolinium-enhanced MR Imaging—Comparison to Prior Same-Center Results after MR Systems Improvements

Becker-Weidman¹,

Kalb²,

Sharma³

et al. 2011

Radiology

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“…However, Pawlik et al (39) demonstrated that the needle core biopsy of HCC to determine histologic grade was inaccurate due to heterogeneous tumor differentiation resulting in sampling errors. Also, there is a risk for needle-tract implantation as a complication of biopsy (40). In such cases, resection of the needle tract should be performed during curative surgery.…”

Section: Needle Biopsymentioning

confidence: 99%

Microvascular invasion in hepatocellular carcinoma

Ünal

İdilman

Akata³

et al. 2016

Diagn Interv Radiol

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H epatocellular carcinoma (HCC) is responsible for high incidence of cancer-related mortality worldwide (1, 2). Diagnosis of HCC is a well-known topic, and now it can be made solely by imaging findings in cirrhosis (3,4). Advances in imaging procedures and intense follow-up of high-risk patients led to increased early detection of HCC and better treatment options (5, 6). However, even in good surgical candidates, long-term survival rates remain unsatisfactory because of high recurrence (7,8). Presence of microvascular invasion (MVI) has been reported to be one of the most important risk factors related to postsurgery tumor recurrence (9-11). Presence of MVI alters the surgical procedure. MVI is a prognostic factor associated with lower survival and higher recurrence rates. Prediction of MVI may also affect locoregional treatments along with chemotherapy protocols. This review will focus on all aspects of MVI. The effect of microvascular invasion on survivalEarly tumor recurrence is linked to increased mortality rate. Lim et al. (9) reported that MVI is a more prominent tumor recurrence predictor than the Milan criteria for HCC after surgical resection. The patients who fulfill the Milan criteria should have a solitary tumor not exceeding 5 cm or three or fewer tumors with the largest not exceeding 3 cm, and no evidence of macrovascular invasion or extrahepatic metastasis (5, 9). Lim et al. (9) concluded that patients (without MVI) exceeding the Milan criteria could achieve comparable overall survival rates after surgical resection, relative to patients within the Milan criteria. However, overall survival decreased significantly with MVI, independently of the Milan criteria.In a different study, authors grouped the patients into mild (one to five invaded vessels) and severe (more than five invaded vessels) MVI groups (5). They found that the three-year recurrence-free survival rates for patients with and without MVI were 27.7% and 62.5%, respectively. They also reported that recurrence-free survival rates at two years for patients without MVI, with mild MVI, and severe MVI were 75.9%, 47.2%, and 32.7%, respectively (5). Goh et al. (12) studied patients who had surgical resection of multifocal HCC and revealed that the presence of MVI and the number of nodules (which is also a result of MVI) were more important prognostic factors than tumor size (12). They also suggested that the current American Joint Committee for Cancer TNM staging system, which uses tumor size, but not MVI, as prognostic criteria for multifocal HCC, needs to be revised (12). The indicators of microvascular invasionDespite its significance in HCC assessment, MVI can rarely be diagnosed preoperatively. However, the presence of MVI may be predicted by key radiologic findings and specific lab- We reviewed the literature and aimed to draw attention to clinicopathologic and imaging findings that may predict the presence of microvascular invasion in hepatocellular carcinoma. Imaging findings suggesting microvascular invasion are disruption of capsule...

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“…One requirement for inclusion was that all malignancies needed to be proven by histology, and the needle type and the followup had to be known as well. They excluded all case reports and patients with seeding after ethanol 19 (2008) Systematic review Histology 3a Durand et al 13 (2001) Prospective and consecutive Histology Good Yes 1b Caturelli et al 12 (2004) Prospective and consecutive Histology Good Yes 1b Huang et al 17 (1996) Retrospective and nonconsecutive Histology Good Yes 3b Takamori et al 24 (2000) Retrospective and nonconsecutive Histology Good Yes 3b Maturen et al 23 (2006) Retrospective and nonconsecutive Histology Good Yes 3b Kosugi et al 22 (2004) Retrospective and nonconsecutive Histology Good Yes 3b Kim et al 21 (2000) Retrospective and nonconsecutive Histology Good Yes 3b Chapoutot et al 20 (1999) Retrospective and nonconsecutive Histology Good Yes 3b Chang et al 26 injection and radiofrequency ablation and all patients with suspected intrahepatic seeding. Finally, they included 8 studies, which were mostly retrospective cross-sectional studies.…”

Section: Question 2 What Are the Complications Of Tumor Biopsy?mentioning

confidence: 99%

“…Finally, they included 8 studies, which were mostly retrospective cross-sectional studies. 12,13,17,[20][21][22][23][24] We identified 4 more studies. [25][26][27][28] Three of these studies were not analyzed because the reference standard was poorly defined 27,28 or some of the patients were not followed up.…”

Section: Question 2 What Are the Complications Of Tumor Biopsy?mentioning

confidence: 99%

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Is tumor biopsy necessary?

et al. 2011

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

Abstract: 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.

Cited by 126 publications

References 4 publications

Hepatocellular Carcinoma Lesion Characterization: Single-Institution Clinical Performance Review of Multiphase Gadolinium-enhanced MR Imaging—Comparison to Prior Same-Center Results after MR Systems Improvements

Hepatocellular Carcinoma Lesion Characterization: Single-Institution Clinical Performance Review of Multiphase Gadolinium-enhanced MR Imaging—Comparison to Prior Same-Center Results after MR Systems Improvements

Microvascular invasion in hepatocellular carcinoma

Is tumor biopsy necessary?

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