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Repeat liver biopsy guided by CT and ultrasound was performed in ten prospectively selected patients with chronic liver disease, small liver size, and a previous unsuccessful biopsy. Biopsy sites selected by both radiographic techniques were essentially similar and within 1 cm of each other. The bulk of the liver was located more posteriorly and superiorly than expected, explaining the failure of the previous unsuccessful biopsies. Adequate cores of liver 1-2.5 cm in length were easily obtained with radiologic guidance. This technique is especially useful in patients with chronic active hepatitis complicated by cirrhosis.