DIAGNOSTIC ROLE OF LIVER MASS BIOPSY AFTER OTHER DIAGNOSTIC WORKUPS IN PATIENTS WITH FOCAL LIVER LESIONS

Purpose: Many contraversial issues sorround the role of liver biopsy in liver mass diagnosis. The aim of this study was to evaluate retrospectively the accuracy of our imaging diagnostic workup without liver biopsy.

Methods and Materials: Between August 2001 and August 2003, 32 consecutive patients with liver mass who had admitted to our department were evaluated. The first diagnosis were established by means of clinical histories, Ultrasonography, and spiral computed tomography. Angiography and Magnetic Resonance Imaging(MRI) were performed when it was considered necessary to plan fine needle biopsy. we investigated all the patients who underwent liver biopsy and results of pathological examination were evaluated for all of them.

Results: Out of 32 patients with liver mass, 29 cases had pathology report. The first diagnosis (before biopsy) of 27 of the 29 patients were completely compatible with pathological result. The respective accuracy, sensivity, specificity, and positive and negative predictive values were 96.5%, 91.6%, 100%, 100% and 94.4% for metastasis diagnosis, 96.5%, 100%, 96.2%, 66.6% and 100% for cholangiocarcinoma, 96.5% 100%, 94.4%, 91.6% and 100% for benign tumors.

Conclusions: According to these results, the fact that the real risks of liver biopsy have not yet to be established and the possibility that tumor seeding and bleeding have a major impact on patient prognosis, the use of liver biopsy should be logically limited.