Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Transjugular liver biopsy in patients with diffuse liver disease
T2 - comparison of three cores with one or two cores for accurate histological interpretation
AU - Cholangitas, E.
AU - Quaglia, Alberto
AU - Samonakis, D.
AU - Mela, M.
AU - Patch, D.
AU - Dhillon, A.P.
AU - Fanshawe, Thomas
AU - Burroughs, A.K.
PY - 2007/6
Y1 - 2007/6
N2 - Background: Transjugular liver biopsy (TJLB) can be performed to obtain more than two cores safely. This advantage has not been evaluated in terms of diagnostic accuracy or grading/staging evaluation.Aim: To evaluate whether three separate cores of TJLB provide more histological information compared with two or one cores.Methods: Twenty-three patients, who had three separate passes, with each core ≥7mm in length using a 19G Tru-cut needle, were evaluated. Each TJLB was blindly coded; the pathologist randomly assessed: (a) each core separately covering the other two, (b) two cores simultaneously covering the third and (c) the three cores together for diagnostic yield, inflammation and fibrosis.Results: The mean TJLB length was 32±5.5mm. In 12 one-core (52%) and 18 2-core (78%) assessments, diagnosis (mainly cirrhosis) was made correctly in each core. The within-patient standard deviations for one-core vs two-core assessment were similar for grading (0.42 and 0.47, respectively), but higher for staging (0.39 and 0.15, respectively). Staging was underestimated in assessing one-core and less for two cores compared to three cores.Conclusion: Three non-fragmented cores (each core ≥7mm in length) of TJLB can be considered a minimum requirement for histological assessment, giving better reproducibility in diagnosis as well as for inflammation and fibrosis.
AB - Background: Transjugular liver biopsy (TJLB) can be performed to obtain more than two cores safely. This advantage has not been evaluated in terms of diagnostic accuracy or grading/staging evaluation.Aim: To evaluate whether three separate cores of TJLB provide more histological information compared with two or one cores.Methods: Twenty-three patients, who had three separate passes, with each core ≥7mm in length using a 19G Tru-cut needle, were evaluated. Each TJLB was blindly coded; the pathologist randomly assessed: (a) each core separately covering the other two, (b) two cores simultaneously covering the third and (c) the three cores together for diagnostic yield, inflammation and fibrosis.Results: The mean TJLB length was 32±5.5mm. In 12 one-core (52%) and 18 2-core (78%) assessments, diagnosis (mainly cirrhosis) was made correctly in each core. The within-patient standard deviations for one-core vs two-core assessment were similar for grading (0.42 and 0.47, respectively), but higher for staging (0.39 and 0.15, respectively). Staging was underestimated in assessing one-core and less for two cores compared to three cores.Conclusion: Three non-fragmented cores (each core ≥7mm in length) of TJLB can be considered a minimum requirement for histological assessment, giving better reproducibility in diagnosis as well as for inflammation and fibrosis.
KW - length
KW - liver biopsy
KW - percutaneous liver biopsy
KW - portal tract
KW - transjugular liver biopsy
KW - size of liver biopsy
U2 - 10.1111/j.1478-3231.2007.01496.x
DO - 10.1111/j.1478-3231.2007.01496.x
M3 - Journal article
VL - 27
SP - 646
EP - 653
JO - Liver International
JF - Liver International
SN - 1478-3231
IS - 5
ER -