Transjugular Liver Biopsy: Comparison of Sample Adequacy with the Use of Two Automated Needle Systems

Abstract

Purpose To compare the adequacy of transjugular liver biopsy (TJLB) specimens with use of the 18-gauge Quick-Core and Flexcore needles. Materials and Methods The records of 233 patients who underwent a TJLB procedure from January 2005 to December 2006 were retrospectively reviewed. Tissue samples from a total of 194 procedures were available for review; 117 TJLB procedures were performed with a Quick-Core needle and 77 were performed with a Flexcore needle. A single pathologist reviewed all the liver biopsy specimens in a blinded fashion. The χ 2, Fisher exact, and Student t tests were used to analyze differences between groups. Results The TJLB procedure was technically successful in 232 of 233 cases (99.6%). Histologic diagnosis was possible in 96% of cases. Sample fragmentation rates were 24.9% with the Quick-Core needle and 14.3% with the Flexcore needle ( P = .1). The mean numbers of complete portal tracts (CPTs) per submitted tissue per procedure were 10.0 ± 4.6 for the Quick-Core needle and 12.2± 6.1 for the Flexcore needle ( P = .003). The mean numbers of CPTs per liver sample were 2.63 ± 1.8 for the Quick-Core needle and 3.28 ± 3.3 for the Flexcore needle ( P = .00004). Complications were more common in patients with multiple comorbidities such as renal failure and coagulopathy and those who had received a liver transplant. Conclusions This study demonstrates that the 18-gauge Flexcore TJLB system provided better liver biopsy specimens compared with the 18-gauge Quick-Core needle system.