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Review article


Imaging-guided Parenchymal Liver Biopsy: How We Do It

Gopal R VijayaraghavanSheehan DavidMyriam Bermudez-AllendeHussain Sarwat
Department of Radiology, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
Date of Submission: 22-Mar-2011, Date of Acceptance: 24-Apr-2011, Date of Web Publication: 15-Jun-2011.
Corresponding Author:
Corresponding Author

Gopal Vijayaraghavan

Department of Radiology, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester 01655, USA.
E-mail: vijayarg@ummhc.org

Corresponding Author:
Corresponding Author

Gopal Vijayaraghavan

Department of Radiology, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester 01655, USA.
E-mail: vijayarg@ummhc.org

DOI: 10.4103/2156-7514.82082 Facebook Twitter Google Linkedin

ABSTRACT


Liver biopsies are performed for both focal and nonfocal lesions (parenchymal). In our center, majority of liver biopsies are performed for parenchymal liver disease. Parenchymal liver biopsy plays a key role in the diagnosis of various diffuse liver dysfunctions. Results of the biopsy help grade the disease, facilitating prognostication, which helps in planning specific treatment strategies. Imaging guidance is gaining wide acceptance as the standard procedure. Ultrasound (US) guidance is currently considered the most cost-effective and safe way to perform parenchymal liver biopsies. Radiologists worldwide and particularly in the United States are increasingly performing this procedure. Radiologists performing biopsies generally use the cutting needle. Different needle sizes, techniques and preference for biopsy of the right or left lobe have been described. We attribute these preferences to prior training and individual radiologist's comfort level. We describe the algorithm followed at our institution for performing percutaneous US-guided parenchymal liver biopsy. While clinical societies have recommended a minimum of 40 liver biopsies as a requirement for proficiency of clinicians, specific to radiology trainees/fellows interested in pursuing a career in intervention, we feel a total of 20 liver biopsies (includes assisted and independently performed biopsies under supervision) should be adequate training.
Keywords: Liver Biopsy, Percutaneous, Ultrasound Guidance

Cited in 10 Documents

  1. Gopal R. Vijayaraghavan, Srinivasan Vedantham, Vikram Rangan, Adib Karam, Larry Zheng, Abhijit Roychowdhury and Sarwat Hussain (2015) Effect of needle gauge and lobe laterality on parenchymal liver biopsy outcome: a retrospective analysis. Abdom Imaging 40(5):1223. doi: 10.1007/s00261-014-0290-y
  2. Corinne Deurdulian and Nicole French (2014) Ultrasound-Guided Intervention in the Abdomen and Pelvis. Ultrasound Clinics 9(4):793. doi: 10.1016/j.cult.2014.07.012
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  8. Lazar Milovanovic (2016) Demystifying Interventional Radiology. (Chapter 7):41. doi: 10.1007/978-3-319-17238-5_7
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