Incidence of major hemorrhage after aggressive image-guided liver mass biopsy in the era of individualized medicine

James H. Boyum, Thomas D. Atwell, Darci J. Wall, Aaron Mansfield, Sarah E. Kerr, Tina M. Gunderson, Kandelaria M. Rumilla, Adam J. Weisbrod, A. Nicholas Kurup

Research output: Contribution to journalArticle

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Abstract

Purpose: To analyze a large volume of image-guided liver mass biopsies to assess for an increased incidence of major hemorrhage after aggressive liver mass sampling, and to determine if coaxial technique reduces major hemorrhage rate. Methods: Patients who underwent image-guided liver mass biopsy over a 15-year period (December 7, 2001–September 22, 2016) were retrospectively identified. An aggressive biopsy was defined as a biopsy event in which ≥ 4 core needle passes were performed. Association of major hemorrhage after aggressive liver mass biopsy and other potential risk factors of interest were assessed using logistic regression analysis. For the subset of aggressive biopsies, Fisher’s exact test was used to compare the incidence of major hemorrhage using coaxial versus noncoaxial techniques. Results: Aggressive biopsies constituted 11.6% of biopsy events (N =579/5011). The incidence of major hemorrhage with <4 passes was 0.4% (N =18/4432) and with ≥4 passes 1.2% (N =6/579). In univariable models, aggressive biopsy was significantly associated with major hemorrhage (OR 3.0, 95% CI 1.16–6.92, p =0.025). After adjusting for gender and platelet count, the association was not significant at the p =0.05 level (OR 2.58, 95% CI 0.927–6.24, p =0.067). The rate of major hemorrhage in the coaxial biopsy technique group was 1.4% (N =3/209) compared to 1.1% (N =4/370) in the noncoaxial biopsy technique group, which was not a significant difference (p =0.707). Conclusions: Although aggressive image-guided liver mass biopsies had an increased incidence of major hemorrhage, the overall risk of bleeding remained low. The benefit of such biopsies will almost certainly outweigh the risk in most patients.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalAbdominal Radiology
DOIs
StateAccepted/In press - May 17 2018

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Precision Medicine
Hemorrhage
Biopsy
Liver
Incidence
Platelet Count
Needles

Keywords

  • Biopsy
  • Hematoma
  • High-pass
  • Liver

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

Incidence of major hemorrhage after aggressive image-guided liver mass biopsy in the era of individualized medicine. / Boyum, James H.; Atwell, Thomas D.; Wall, Darci J.; Mansfield, Aaron; Kerr, Sarah E.; Gunderson, Tina M.; Rumilla, Kandelaria M.; Weisbrod, Adam J.; Kurup, A. Nicholas.

In: Abdominal Radiology, 17.05.2018, p. 1-7.

Research output: Contribution to journalArticle

Boyum, James H. ; Atwell, Thomas D. ; Wall, Darci J. ; Mansfield, Aaron ; Kerr, Sarah E. ; Gunderson, Tina M. ; Rumilla, Kandelaria M. ; Weisbrod, Adam J. ; Kurup, A. Nicholas. / Incidence of major hemorrhage after aggressive image-guided liver mass biopsy in the era of individualized medicine. In: Abdominal Radiology. 2018 ; pp. 1-7.
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abstract = "Purpose: To analyze a large volume of image-guided liver mass biopsies to assess for an increased incidence of major hemorrhage after aggressive liver mass sampling, and to determine if coaxial technique reduces major hemorrhage rate. Methods: Patients who underwent image-guided liver mass biopsy over a 15-year period (December 7, 2001–September 22, 2016) were retrospectively identified. An aggressive biopsy was defined as a biopsy event in which ≥ 4 core needle passes were performed. Association of major hemorrhage after aggressive liver mass biopsy and other potential risk factors of interest were assessed using logistic regression analysis. For the subset of aggressive biopsies, Fisher’s exact test was used to compare the incidence of major hemorrhage using coaxial versus noncoaxial techniques. Results: Aggressive biopsies constituted 11.6{\%} of biopsy events (N =579/5011). The incidence of major hemorrhage with <4 passes was 0.4{\%} (N =18/4432) and with ≥4 passes 1.2{\%} (N =6/579). In univariable models, aggressive biopsy was significantly associated with major hemorrhage (OR 3.0, 95{\%} CI 1.16–6.92, p =0.025). After adjusting for gender and platelet count, the association was not significant at the p =0.05 level (OR 2.58, 95{\%} CI 0.927–6.24, p =0.067). The rate of major hemorrhage in the coaxial biopsy technique group was 1.4{\%} (N =3/209) compared to 1.1{\%} (N =4/370) in the noncoaxial biopsy technique group, which was not a significant difference (p =0.707). Conclusions: Although aggressive image-guided liver mass biopsies had an increased incidence of major hemorrhage, the overall risk of bleeding remained low. The benefit of such biopsies will almost certainly outweigh the risk in most patients.",
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T1 - Incidence of major hemorrhage after aggressive image-guided liver mass biopsy in the era of individualized medicine

AU - Boyum, James H.

AU - Atwell, Thomas D.

AU - Wall, Darci J.

AU - Mansfield, Aaron

AU - Kerr, Sarah E.

AU - Gunderson, Tina M.

AU - Rumilla, Kandelaria M.

AU - Weisbrod, Adam J.

AU - Kurup, A. Nicholas

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N2 - Purpose: To analyze a large volume of image-guided liver mass biopsies to assess for an increased incidence of major hemorrhage after aggressive liver mass sampling, and to determine if coaxial technique reduces major hemorrhage rate. Methods: Patients who underwent image-guided liver mass biopsy over a 15-year period (December 7, 2001–September 22, 2016) were retrospectively identified. An aggressive biopsy was defined as a biopsy event in which ≥ 4 core needle passes were performed. Association of major hemorrhage after aggressive liver mass biopsy and other potential risk factors of interest were assessed using logistic regression analysis. For the subset of aggressive biopsies, Fisher’s exact test was used to compare the incidence of major hemorrhage using coaxial versus noncoaxial techniques. Results: Aggressive biopsies constituted 11.6% of biopsy events (N =579/5011). The incidence of major hemorrhage with <4 passes was 0.4% (N =18/4432) and with ≥4 passes 1.2% (N =6/579). In univariable models, aggressive biopsy was significantly associated with major hemorrhage (OR 3.0, 95% CI 1.16–6.92, p =0.025). After adjusting for gender and platelet count, the association was not significant at the p =0.05 level (OR 2.58, 95% CI 0.927–6.24, p =0.067). The rate of major hemorrhage in the coaxial biopsy technique group was 1.4% (N =3/209) compared to 1.1% (N =4/370) in the noncoaxial biopsy technique group, which was not a significant difference (p =0.707). Conclusions: Although aggressive image-guided liver mass biopsies had an increased incidence of major hemorrhage, the overall risk of bleeding remained low. The benefit of such biopsies will almost certainly outweigh the risk in most patients.

AB - Purpose: To analyze a large volume of image-guided liver mass biopsies to assess for an increased incidence of major hemorrhage after aggressive liver mass sampling, and to determine if coaxial technique reduces major hemorrhage rate. Methods: Patients who underwent image-guided liver mass biopsy over a 15-year period (December 7, 2001–September 22, 2016) were retrospectively identified. An aggressive biopsy was defined as a biopsy event in which ≥ 4 core needle passes were performed. Association of major hemorrhage after aggressive liver mass biopsy and other potential risk factors of interest were assessed using logistic regression analysis. For the subset of aggressive biopsies, Fisher’s exact test was used to compare the incidence of major hemorrhage using coaxial versus noncoaxial techniques. Results: Aggressive biopsies constituted 11.6% of biopsy events (N =579/5011). The incidence of major hemorrhage with <4 passes was 0.4% (N =18/4432) and with ≥4 passes 1.2% (N =6/579). In univariable models, aggressive biopsy was significantly associated with major hemorrhage (OR 3.0, 95% CI 1.16–6.92, p =0.025). After adjusting for gender and platelet count, the association was not significant at the p =0.05 level (OR 2.58, 95% CI 0.927–6.24, p =0.067). The rate of major hemorrhage in the coaxial biopsy technique group was 1.4% (N =3/209) compared to 1.1% (N =4/370) in the noncoaxial biopsy technique group, which was not a significant difference (p =0.707). Conclusions: Although aggressive image-guided liver mass biopsies had an increased incidence of major hemorrhage, the overall risk of bleeding remained low. The benefit of such biopsies will almost certainly outweigh the risk in most patients.

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KW - Hematoma

KW - High-pass

KW - Liver

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