title: Fine needle aspiration biopsy for improving the diagnostic accuracy of cut needle biopsy of focal liver lesions.
abstract: OBJECTIVE
  To determine the value of fine needle aspiration biopsy (FNAB) in comparison to cut needle biopsy (CNB) for the diagnosis of malignancy of focal liver lesions.
  
  
  METHODS
  A retrospective analysis was conducted on 68 FNAB and 49 CNB procedures performed on 62 patients with focal liver lesions.
  
  
  RESULTS
  Cytology permitted a diagnosis of the lesion in 78% of cases. When punctures with insufficient material were excluded (11), the diagnostic accuracy of FNAB was 93%. For the 49 patients who underwent both procedures, FNAB and CNB had the same diagnostic accuracy, 78%, when considered separately and of 88% when considered in combination. Sensitivity, specificity and positive predictive value were similar for the 2 techniques. The negative predictive value was 64% for FNAB and CNB used separately and reached 78% when the 2 techniques were combined. There were no complications during the execution of FNAB and CNB.
  
  
  CONCLUSIONS
  FNAB is an effective and safe method for the diagnosis of focal hepatic lesions, with diagnostic accuracy similar to that of CNB. When the 2 techniques are combined, the accuracy of the diagnosis of malignancy of focal liver lesions increases.
authors.affiliation: Hepatology Unit, Division of Gastroenterology, Department of Medicine, Medical School of Ribeirão Preto, Sõ Paulo University, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, Brazil. avcfranca@hcrp.fmrp.usp.br
authors.forename: Alex Vianey Callado
authors.initials: AV
authors.lastname: França
authors.forename: Helena Maria Giordano
authors.initials: HM
authors.lastname: Valério
authors.forename: Mirian
authors.initials: M
authors.lastname: Trevisan
authors.forename: Cecília
authors.initials: C
authors.lastname: Escanhoela
authors.forename: Tiago
authors.initials: T
authors.lastname: Sevá-Pereira
authors.forename: Sérgio
authors.initials: S
authors.lastname: Zucoloto
authors.forename: Ana
authors.initials: A
authors.lastname: Martinelli
authors.forename: Elza Cotrim
authors.initials: EC
authors.lastname: Soares
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000473:pathology; D003951:Diagnostic Errors / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity