Ultrasound-Guided Percutaneous Biopsy With Needle Track Plugging in Patients With Focal Liver Lesions on an Outpatient Basis: A Randomized Controlled Trial.

IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Ja Kyung Yoon, Choong-Kun Lee, Hongjeong Yoon, Hye Jin Choi, Seung-Seob Kim
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引用次数: 0

Abstract

Objective: The increasing utilization of various molecular tests for diagnosing and selecting treatments for patients with malignancies has led to a rising trend in both the frequency of biopsies and the required tissue volume. We aimed to compare the safety of outpatient ultrasound (US)-guided percutaneous liver biopsy (PLB) between the coaxial method with needle track plugging (NTP) and the conventional method.

Materials and methods: This single-center, prospective, randomized controlled study was conducted from October 2022 to May 2023. Patients referred for US-guided PLB with target liver lesions measuring ≥1 cm and requiring ≥3 tissue cores were enrolled. Patients with severe coagulopathy or a substantial volume of ascites were excluded. Patients were randomly assigned to undergo PLB using either the coaxial method with NTP or the conventional method, in a 1:1 ratio, and were subsequently discharged after 2 hours. The primary endpoint was the presence of a patent track sign, defined as a linear color flow along the biopsy track on Doppler US, as an indication of bleeding. The secondary endpoints included clinically significant bleeding, delayed bleeding after discharge, and diagnostic yield. The incidences of these endpoints were compared between the two methods.

Results: A total of 107 patients completed the study protocol. Patent track signs were observed significantly less frequently in the coaxial method with NTP group than in the conventional method group: 16.7% (9/54) vs. 35.8% (19/53; P = 0.042). Clinically significant bleeding and delayed bleeding did not occur in either group, and both methods achieved a high diagnostic yield: 94.4% (51/54) vs. 98.1% (52/53; P = 0.624).

Conclusion: Compared with the conventional method, the coaxial method with NTP may potentially be safer, with a reduced risk of overall bleeding complications after PLB when retrieving ≥3 tissue cores. The coaxial method with NTP could be considered a viable option for acquiring multiple liver tissues on an outpatient basis.

门诊病灶性肝损伤患者在超声引导下进行针道堵塞经皮活检:随机对照试验
目的:随着恶性肿瘤患者越来越多地使用各种分子检验来诊断和选择治疗方法,活检的频率和所需组织量都呈上升趋势。我们的目的是比较超声(US)引导的门诊经皮肝活检(PLB)与针道堵塞(NTP)同轴法和传统方法的安全性:这项单中心、前瞻性、随机对照研究于2022年10月至2023年5月进行。研究对象为在 US 引导下进行 PLB 的肝脏靶病变≥1 厘米且需要≥3 个组织核的患者。有严重凝血功能障碍或大量腹水的患者被排除在外。患者按照 1:1 的比例被随机分配到使用 NTP 同轴法或传统方法进行 PLB,然后在 2 小时后出院。主要终点是出现通畅径迹征象,即多普勒超声显示活检径迹出现线性彩色血流,作为出血迹象。次要终点包括有临床意义的出血、出院后延迟出血和诊断率。对两种方法的终点发生率进行了比较:共有 107 名患者完成了研究方案。在使用 NTP 的同轴法组中,观察到闭塞性径迹征的频率明显低于传统方法组:16.7%(9/54)对 35.8%(19/53;P = 0.042)。两组均未出现临床明显出血和延迟出血,两种方法的诊断率都很高:94.4%(51/54)vs 98.1%(52/53;P = 0.624):结论:与传统方法相比,带有 NTP 的同轴方法可能更安全,当取回≥3 个组织核时,PLB 后总体出血并发症的风险更低。带NTP的同轴法可被视为在门诊获取多个肝脏组织的可行方案。
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来源期刊
Korean Journal of Radiology
Korean Journal of Radiology 医学-核医学
CiteScore
10.60
自引率
12.50%
发文量
141
审稿时长
1.3 months
期刊介绍: The inaugural issue of the Korean J Radiol came out in March 2000. Our journal aims to produce and propagate knowledge on radiologic imaging and related sciences. A unique feature of the articles published in the Journal will be their reflection of global trends in radiology combined with an East-Asian perspective. Geographic differences in disease prevalence will be reflected in the contents of papers, and this will serve to enrich our body of knowledge. World''s outstanding radiologists from many countries are serving as editorial board of our journal.
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