Endoscopic ultrasound-guided fine-needle aspiration can target right liver mass

Abstract

Background and Objectives:Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been established as a safe and accurate method for diagnosing and staging intra-abdominal mass. However, few studies investigated its feasibility, efficacy, and safety for targeting liver mass. We evaluated the efficacy and safety of EUS-FNA in patients with liver masses including the right lobe.Patients and Methods:The technical feasibility, safety, and diagnostic yield were determined in 47 patients (30 in the left lobe and 17 in the right lobe) presenting with liver masses between September 2010 and February 2016.Results:Thirty-eight patients (80.9%) had malignancies whereas nine patients (19.1%) had benign liver masses. Technical success rate was 97.9% (46/47). EUS-FNA was diagnostic in 38 of 42 patients (90.5%). When the outcomes of EUS-FNA between right liver mass and left mass were accessed, the technical success rates were similar in both lobes (100% vs. 94.1%, P = 0.2). The median tumor size on EUS (25.5 mm, interquartile range [IQR] 13.8–30.3 vs. 28 mm, IQR 18.5–43.5, P = 0.24) and number of needle passes (3, IQR 3–4 vs. 3, IQR 3–3, P = 0.24) were not significantly different. Adequate specimen obtained was statistically higher in the left lobe (28/30, 93.3% vs. 14/17, 82.4%, P = 0.04). However, diagnostic accuracy for liver masses was not different (25/28, 89.3% vs. 13/14, 92.9%, P = 0.86). No complications developed after procedure.Conclusions:EUS-FNA can be a safe and efficient method for the diagnosis of liver mass and it is technically feasible even for those in the right lobe.

Diagnostic yield of endoscopic ultrasound-guided biopsy of focal liver lesions

“…EUS can chart the detailed anatomy of the liver from transgastric and transduodenal routes. Viewing and sampling the right posterior segments is laborious but achievable [23,27]. In addition, EUS offers the potential for a precise biopsy for histology/cytology examination.…”

Endoscopic Ultrasound-Guided Fine-Needle Aspiration (EUS-FNA) with Image Enhancement

“…However, EUS can identify very small (<1 cm) liver metastases as well as allowing for concurrent FNA to aid in the staging of certain malignancies. EUS-FNA has a sensitivity of 82-98% for the diagnosis of malignant liver metastases [73][74][75][76][77][78][79].…”

A Comprehensive Narrative Review on the Evolving Role of Endoscopic Ultrasound in Focal Solid Liver Lesions Diagnosis and Management

“…EUS-guided liver biopsy (EUS-LB) has gained a great popularity since its first description and is currently considered to have at least the same efficacy compared to the traditional methods of performing liver biopsy from focal lesions [29]. EUS-LB has several advantages over the percutaneous and trans-jugular routes, including better safety profile [30], real-time high quality imaging of both liver lobes, and enabling access to the target focal lesions, thus avoiding intervening blood vessels and adjacent structures, as well as providing a real-time detailed view of the biopsy needle route during tissue acquisition through the liver [31][32][33]. Furthermore, EUS-LB is performed under sedation, guaranteeing reduced procedural anxiety and increased patient comfort [34,35].…”