Sampling Variability and Its Influence on the Diagnostic Yield of Percutaneous Needle Biopsy of the Liver

Maharaj, B; Maharaj, R J; Leary, W. P.; Cooppan, R M; Naran, A. D.; Pirie, D J; Pudifin, D J

doi:10.1016/s0140-6736(86)90883-4

Cited by 571 publications

(342 citation statements)

References 8 publications

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“…Autopsy and laparoscopy studies have demonstrated that cirrhosis is missed on a single blind liver biopsy in between 10% and 30% of cases. [15][16][17] The recent study by Regev et al concerning laparoscopic liver biopsy of both left and right lobes observed that cirrhosis was noted on one side but not the other in 14.5% of cases, and, in 33.1% of patients, a difference of at least one fibrosis stage between lobes was found. 2 Both the size of the biopsy sample and the number of biopsy samples taken have a major effect on sampling error.…”

Section: Liver Biopsymentioning

confidence: 98%

Diagnosis and Quantitation of Fibrosis

2008

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Section: Liver Biopsymentioning

confidence: 98%

Diagnosis and Quantitation of Fibrosis

2008

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“…To accurately diagnose diffuse liver disease, a biopsy specimen must reliably represent the abnormalities throughout the hepatic parenchyma. In several species important lesions are distributed throughout the liver in consistent relationship with hepatic architecture 3, 4, 5, 6, 7. Whereas a good quality biopsy would be expected to reveal most of these lesions, biopsy collects only a small portion of tissue and error associated with nonhomogenous distribution of disease is possible.…”

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confidence: 99%

“…Whereas a good quality biopsy would be expected to reveal most of these lesions, biopsy collects only a small portion of tissue and error associated with nonhomogenous distribution of disease is possible. In humans, hepatopathies considered diffuse can have unevenly distributed histopathologic changes 3, 4, 5, 6, 7. However, caution must be used when extrapolating results in humans to dogs.…”

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confidence: 99%

Histopathologic Variation between Liver Lobes in Dogs

Kemp

Zimmerman

Panciera

et al. 2015

Veterinary Internal Medicne

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BackgroundBiopsy of the liver evaluates a small portion of tissue, with inferences made to the entire organ. The method and number of biopsies obtained are tempered by consideration of the risks and benefits. Recommendations often include biopsy of more than one liver lobe, although the consistency of histopathology among lobes in dogs is unknown.Hypothesis/ObjectivesTo describe the distribution of histopathologic abnormalities between liver lobes. We hypothesized that discordant results would be evenly distributed among all liver lobes.AnimalsSeventy dogs undergoing necropsy.MethodsProspective study. Liver samples were obtained from all lobes. A primary diagnosis was assigned to each liver sample based on the predominant histopathologic abnormality.ResultsIn this population of dogs, biopsy of at least 2 liver lobes identified the predominant histologic abnormality in 98.6% of the cases. Ten (14%) of the dogs had ≤3 lobes in agreement and could not be assigned a predominant diagnosis. The same diagnosis was present in 6/6 lobes in 39 (56.5%) dogs, 5/6 lobes in 10 (14.5%) dogs, 4/6 lobes in 10 (14.5%) dogs, 3/6 lobes in 7 (10.1%) dogs, and 2/6 in 3 (4.3%) dogs. The number of discordant results did not differ between the liver lobes.Conclusion and Clinical ImportanceThe likelihood of obtaining a sample that is reflective of the predominant histologic abnormality in the liver is increased when multiple liver lobes are biopsied.

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“…105(4): 467-470, July 2010 The gold standard method in evaluating schistosomal hepatic fibrosis was wedge liver biopsy, a safe procedure performed during abdominal surgery, but not justified in non-surgical patients. An alternative procedure, percutaneous liver biopsy, has low sensitivity because it retrieves small and fragmented samples with few portal tracts (Bogliolo 1957, Cheever 1968, Maharaj et al 1986). …”

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confidence: 99%

Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity

Silva

Andrade

Queiroz

et al. 2010

Mem. Inst. Oswaldo Cruz

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For the last two decades, ultrasound (US) has been considered a surrogate for the gold standard in the evaluation of liver fibrosis in schistosomiasis. The use of magnetic resonance imaging (MRI) is not yet standardised for diagnosing and grading liver schistosomal fibrosis. The aim of this paper was to analyse MRI using an adaptation of World Health Organization (WHO) patterns for US assessment of schistosomiasis-related morbidity. US and MRI were independently performed in 60 patients (42.1 ± 13.4 years old), including 37 men and 23 women with schistosomiasis. Liver involvement appraised by US and MRI was classified according to the WHO protocol from patterns A-F. Agreement between image methods was evaluated by kappa index (k). The correlation between US and MRI was poor using WHO patterns [k = 0.14; confidence interval (CI) 0.02; 0.26]. Even after grouping image patterns as "A-D", "Dc-E" and "Ec-F", the correlation between US and MRI remained weak (k = 0.39; CI 0.21; 0.58). The magnetic resonance adaptation used in our study did not confirm US classification of WHO patterns for liver fibrosis

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Sampling Variability and Its Influence on the Diagnostic Yield of Percutaneous Needle Biopsy of the Liver

Cited by 571 publications

References 8 publications

Diagnosis and Quantitation of Fibrosis

Diagnosis and Quantitation of Fibrosis

Histopathologic Variation between Liver Lobes in Dogs

Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity

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