Comparative Study of an Ultrasound-guided Percutaneous Biopsy and Endoscopic Ultrasound-guided Fine-needle Aspiration for Liver Tumors

Abstract

Objective Both a percutaneous biopsy and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) have been widely performed for liver tumors. However, no studies have compared these two biopsy methods. Method A retrospective study was conducted using medical records for patients who underwent a liver tumor biopsy from 2012 to 2019. The cases were classified into two groups for a comparison: an ultrasound-guided percutaneous biopsy group (percutaneous group) and an EUS-FNA group (EUS group). Results A total of 106 patients (47 in the percutaneous group and 59 in the EUS group) were included. The final diagnosis was malignant in 100 cases and benign in the remaining 6 cases. While the median lesion diameter was 62 mm in the percutaneous group, it was significantly smaller (34 mm) in the EUS group (p <0.01). The EUS group had more left lobe tumors than right lobe tumors. All cases of caudate lobe tumor (four cases) underwent EUS-FNA. The sensitivity, specificity, and accuracy of the procedure were 95%, 100%, and 96% in the percutaneous group and 100%, 100%, and 100% in the EUS group, respectively showing no significant difference. Adverse events were reported in 17% of the percutaneous group, which was significantly lower than in the EUS group (2%; p <0.01). Conclusion A percutaneous biopsy and EUS-FNA have equivalent diagnostic qualities for liver tumors, although EUS-FNA tends to be associated with fewer adverse events. A complete understanding of the characteristics of each procedure is essential when choosing the best biopsy method for each particular case.

Endoscopic Ultrasound-Guided Tissue Sampling for the Cytohistological Diagnosis of Focal Liver Lesions

“…Few published studies exist comparing the diagnostic accuracy of EUS-guided tissue acquisition with traditional percutaneous biopsy in focal liver lesions. In the recent study by Takano et al [ 30 ], involving 106 patients (47 in the percutaneous group and 59 in the EUS group), EUS-guided tissue acquisition demonstrated similar accuracy and yielded samples of comparable quality to percutaneous biopsy, but with a lower rate of adverse events. Additionally, the EUS method may offer benefits such as shorter patient recovery time, lower levels of anxiety, and the ability to perform a gastrointestinal endoscopic and biliopancreatic endosonographic examination simultaneously with the biopsy (8).…”

Endoscopic ultrasound‐guided tissue acquisition for focal liver lesions in patients with a history of multiple primary malignant neoplasms

“…Results were favorable, with 88%–100% sensitivity, 99%–100% specificity, and 0%–6% incidence of adverse events. 5 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 EUS‐TA is particularly useful in cases in which percutaneous biopsy is difficult, such as small liver lesions, severe obesity, caudate lobe lesions, and massive ascites. 19 …”

Endoscopic Ultrasound-Guided Fine-Needle Biopsy versus Fine-Needle Aspiration in the Diagnosis of Focal Liver Lesions: Prospective Head-to-Head Comparison

“…The rate of EUS-FNA diagnosis varied between 75 to 100% with two to three needle passes [ 28 ], even when an ultrasound contrast agent was used to highlight the lesion [ 10 ]. The results of EUS-FNA are comparable to those of percutaneous biopsy, with a lower adverse events rate (2% vs. 17%) [ 29 ]. In our study, one pass of FNA provided 86.7% accuracy, similar to the 86.3% accuracy reported by Akay et al [ 9 ] but with a reduced possibility of IHC (histology score of 4 out of 5).…”