Cargando…

The Feasibility of Liver Biopsy for Undefined Nodules in Patients under Surveillance for Hepatocellular Carcinoma: Is Biopsy Really a Useful Tool?

Background: The aim of the present study is to determine the feasibility of biopsy for atypical liver nodules in patients under surveillance for hepatocellular carcinoma (HCC), assessing which factors influence the decision to perform it. Methods: A total of 128 atypical liver nodules in 108 patient...

Descripción completa

Detalles Bibliográficos
Autores principales: Renzulli, Matteo, Pecorelli, Anna, Brandi, Nicolò, Brocchi, Stefano, Tovoli, Francesco, Granito, Alessandro, Carrafiello, Gianpaolo, Ierardi, Anna Maria, Golfieri, Rita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369413/
https://www.ncbi.nlm.nih.gov/pubmed/35956016
http://dx.doi.org/10.3390/jcm11154399
_version_ 1784766450372706304
author Renzulli, Matteo
Pecorelli, Anna
Brandi, Nicolò
Brocchi, Stefano
Tovoli, Francesco
Granito, Alessandro
Carrafiello, Gianpaolo
Ierardi, Anna Maria
Golfieri, Rita
author_facet Renzulli, Matteo
Pecorelli, Anna
Brandi, Nicolò
Brocchi, Stefano
Tovoli, Francesco
Granito, Alessandro
Carrafiello, Gianpaolo
Ierardi, Anna Maria
Golfieri, Rita
author_sort Renzulli, Matteo
collection PubMed
description Background: The aim of the present study is to determine the feasibility of biopsy for atypical liver nodules in patients under surveillance for hepatocellular carcinoma (HCC), assessing which factors influence the decision to perform it. Methods: A total of 128 atypical liver nodules in 108 patients under surveillance for HCC, who underwent CT between September 2018 and September 2019, were included. All the images were saved digitally (on CD-ROM) and the two most representative images in the arterial and delayed phases were selected for each lesion and inserted into a digital atlas (on PDF). Two experienced radiologists (Readers 1 and 2) reviewed both the CD-ROM and the PDF to define the feasibility of biopsy in both scenarios, specifying the reasons for the unfeasibility of biopsy. The intra-observer variability and inter-observer variability were assessed. Results: When reviewing the PDF, 76 (59.4%) and 68 (53.1%) nodules were deemed unfeasible for biopsy by the less experienced radiologist (Reader 1) and the more experienced radiologist (Reader 2), respectively (p = 0.604). When reviewing the entire CT study, both percentages decreased slightly (Reader 1 = 70/128 (54.7%); Reader 2 = 61/128 (47.6%); p = 0.591). The intra-reader agreement on the PDF was substantial (k = 0.648 (95% CI = 0.513–0.783)). The inter-reader agreement on the PDF was slight (k = 0.185 (95% CI = 0.021–0.348)) and moderate on the entire CT study (k = 0.424 (95% CI = 0.269–0.579)). When assessing the PDF, the nodule size (10–20 mm) and location in segments six and eight were negatively and positively associated with the feasibility of liver biopsy, respectively. When assessing the CD-ROM, only the nodule dimension was associated with the unfeasibility of liver biopsy. Conclusions: The unfeasibility of liver biopsy is mainly due to the small size of the lesions and their location.
format Online
Article
Text
id pubmed-9369413
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-93694132022-08-12 The Feasibility of Liver Biopsy for Undefined Nodules in Patients under Surveillance for Hepatocellular Carcinoma: Is Biopsy Really a Useful Tool? Renzulli, Matteo Pecorelli, Anna Brandi, Nicolò Brocchi, Stefano Tovoli, Francesco Granito, Alessandro Carrafiello, Gianpaolo Ierardi, Anna Maria Golfieri, Rita J Clin Med Article Background: The aim of the present study is to determine the feasibility of biopsy for atypical liver nodules in patients under surveillance for hepatocellular carcinoma (HCC), assessing which factors influence the decision to perform it. Methods: A total of 128 atypical liver nodules in 108 patients under surveillance for HCC, who underwent CT between September 2018 and September 2019, were included. All the images were saved digitally (on CD-ROM) and the two most representative images in the arterial and delayed phases were selected for each lesion and inserted into a digital atlas (on PDF). Two experienced radiologists (Readers 1 and 2) reviewed both the CD-ROM and the PDF to define the feasibility of biopsy in both scenarios, specifying the reasons for the unfeasibility of biopsy. The intra-observer variability and inter-observer variability were assessed. Results: When reviewing the PDF, 76 (59.4%) and 68 (53.1%) nodules were deemed unfeasible for biopsy by the less experienced radiologist (Reader 1) and the more experienced radiologist (Reader 2), respectively (p = 0.604). When reviewing the entire CT study, both percentages decreased slightly (Reader 1 = 70/128 (54.7%); Reader 2 = 61/128 (47.6%); p = 0.591). The intra-reader agreement on the PDF was substantial (k = 0.648 (95% CI = 0.513–0.783)). The inter-reader agreement on the PDF was slight (k = 0.185 (95% CI = 0.021–0.348)) and moderate on the entire CT study (k = 0.424 (95% CI = 0.269–0.579)). When assessing the PDF, the nodule size (10–20 mm) and location in segments six and eight were negatively and positively associated with the feasibility of liver biopsy, respectively. When assessing the CD-ROM, only the nodule dimension was associated with the unfeasibility of liver biopsy. Conclusions: The unfeasibility of liver biopsy is mainly due to the small size of the lesions and their location. MDPI 2022-07-28 /pmc/articles/PMC9369413/ /pubmed/35956016 http://dx.doi.org/10.3390/jcm11154399 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Renzulli, Matteo
Pecorelli, Anna
Brandi, Nicolò
Brocchi, Stefano
Tovoli, Francesco
Granito, Alessandro
Carrafiello, Gianpaolo
Ierardi, Anna Maria
Golfieri, Rita
The Feasibility of Liver Biopsy for Undefined Nodules in Patients under Surveillance for Hepatocellular Carcinoma: Is Biopsy Really a Useful Tool?
title The Feasibility of Liver Biopsy for Undefined Nodules in Patients under Surveillance for Hepatocellular Carcinoma: Is Biopsy Really a Useful Tool?
title_full The Feasibility of Liver Biopsy for Undefined Nodules in Patients under Surveillance for Hepatocellular Carcinoma: Is Biopsy Really a Useful Tool?
title_fullStr The Feasibility of Liver Biopsy for Undefined Nodules in Patients under Surveillance for Hepatocellular Carcinoma: Is Biopsy Really a Useful Tool?
title_full_unstemmed The Feasibility of Liver Biopsy for Undefined Nodules in Patients under Surveillance for Hepatocellular Carcinoma: Is Biopsy Really a Useful Tool?
title_short The Feasibility of Liver Biopsy for Undefined Nodules in Patients under Surveillance for Hepatocellular Carcinoma: Is Biopsy Really a Useful Tool?
title_sort feasibility of liver biopsy for undefined nodules in patients under surveillance for hepatocellular carcinoma: is biopsy really a useful tool?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369413/
https://www.ncbi.nlm.nih.gov/pubmed/35956016
http://dx.doi.org/10.3390/jcm11154399
work_keys_str_mv AT renzullimatteo thefeasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT pecorellianna thefeasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT brandinicolo thefeasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT brocchistefano thefeasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT tovolifrancesco thefeasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT granitoalessandro thefeasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT carrafiellogianpaolo thefeasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT ierardiannamaria thefeasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT golfieririta thefeasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT renzullimatteo feasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT pecorellianna feasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT brandinicolo feasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT brocchistefano feasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT tovolifrancesco feasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT granitoalessandro feasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT carrafiellogianpaolo feasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT ierardiannamaria feasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool
AT golfieririta feasibilityofliverbiopsyforundefinednodulesinpatientsundersurveillanceforhepatocellularcarcinomaisbiopsyreallyausefultool