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An Audit to Evaluate the Technique, Diagnostic Adequacy and Safety of Percutaneous Ultrasound Guided Liver Biopsy.
EP29140
Poster Title: An Audit to Evaluate the Technique, Diagnostic Adequacy and Safety of Percutaneous Ultrasound Guided Liver Biopsy.
Submitted on 13 Sep 2018
Author(s): S Gawley, L Saraswat, L Narayanan
Affiliations: Aberdeen Royal Infirmary, NHS Grampian
This poster was presented at BIR
Poster Views: 266
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Poster Information
Abstract: Purpose
We noted that there was a considerable variation in liver biopsy practice in our hospital. As needle size and number of passes increase so does the incidence of complications (reference 1). We wished to document liver biopsy technique in order to help standardise future practice. We also wished to check our diagnostic adequacy and complication rates against national guidelines.

Target
Diagnostic adequacy > 98% (RCR standard - reference 1).
Complication rates to meet RCR standard (references 1, 3).

Method
• A search for all targeted and non-targeted liver biopsies performed from 1/8/16-31/7/17 inclusive.
• Details on each patient were obtained from computerised patient records (SCI Store).

Results
52 targeted and 51 non-targeted liver biopsies.
• Variability in accuracy of report.
• 16G commonest gauge of needle used for both targeted and non-targeted procedures.
• Overall 2 cores commonest for both groups.
• High diagnostic adequacy, 94% in targeted group just below audit standard, 100% in non-targeted group.
• Few complications, complication rate meets RCR standards except for adjacent organ puncture in non-targeted group but this related to only one case.
• Audit has shown that one core for a non-targeted biopsy using 16G needle is diagnostic (100%).

Conclusions
• 16G is thought to be the optimum needle size for both targeted and non-targeted liver biopsies.
• At least 2 core samples recommended in targeted cases, while a single core could suffice in non-targeted cases especially using 16G needle.
• Standardisation of reports, use macro for reporting.
Summary: 16G is thought to be the optimum needle size for both targeted and non-targeted liver biopsies.
At least 2 core samples recommended in targeted cases, while a single core could suffice in non-targeted cases especially using 16G needle.
High diagnostic adequacy achieved and low complication rates.
Standardisation of reports, see suggested macro.

References: 1. The Royal College of Radiologists. An Audit to Evaluate the Diagnostic Adequacy and Safety of Percutaneous Image Guided Liver Biopsy. http://www.rcr.ac.uk/

2. Howlett DC et al. Findings of the UK National Audit Evaluating Image-guided or Image-assisted Liver Biopsy. Part 1. Procedural Aspects, Diagnostic Adequacy, and Accuracy. Radiology 2012; 265(3):819-31

3. Howlett DC et al. Findings of the UK National Audit Evaluating Image-guided or Image-assisted Liver Biopsy. Part II. Minor and Major Complications and Procedure-related Mortality. Radiology 2013; 266(1):226-235
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