A French study, conducted by Francois Durand and colleagues, has examined the incidence of needle tract seeding in ultrasound (US) guided biopsy for the diagnosis of hepatocellular carcinoma (HCC).
In addition, the study also examined the usefulness, accuracy, and safety of this technique.
137 patients were included in the study, which was carried out over a 10-year period from 1986, in Paris, France.
All patients recruited to the survey underwent US-guided biopsy before resection or transplantation for suspected HCC.
The results of liver biopsies were used for comparison with analyses of resected livers. The mean follow-up assessment time was 38 months.
|Less than 2% of patients developed needle-tract seeding.|
|Journal of Hepatology|
Biopsies established a diagnosis of HCC in 122 patients (89%).
Following surgery, 13 of the 15 patients with negative biopsies were also shown to have HCC. The remaining 2 patients had non-malignant modules.
US-guided biopsies were found to have a sensitivity and accuracy of 90% and 91%, respectively.
Location of the nodule, but not its size, was a significant factor in influencing the level of accuracy that could be achieved.
Only 2 patients (1.6%) suffered needle-tract seeding. No recurrence was observed after local excision.
The research group concluded that the low incidence of needle-tract seeding should be balanced against the risk of deciding on an aggressive treatment in a patient without proven malignancy.
They further added that patients with negative biopsy should undergo a second biopsy and/or repeated investigations by imaging techniques.