title: Transjugular liver biopsy: comparison of sample adequacy with the use of two automated needle systems.
abstract: OBJECTIVE
  To compare the adequacy of transjugular liver biopsy (TJLB) specimens with use of the 18-gauge Quick-Core and Flexcore needles.
  
  
  METHODS
  The records of 233 patients who underwent a TJLB procedure from January 2005 to December 2006 were retrospectively reviewed. Tissue samples from a total of 194 procedures were available for review; 117 TJLB procedures were performed with a Quick-Core needle and 77 were performed with a Flexcore needle. A single pathologist reviewed all the liver biopsy specimens in a blinded fashion. The χ(2), Fisher exact, and Student t tests were used to analyze differences between groups.
  
  
  RESULTS
  The TJLB procedure was technically successful in 232 of 233 cases (99.6%). Histologic diagnosis was possible in 96% of cases. Sample fragmentation rates were 24.9% with the Quick-Core needle and 14.3% with the Flexcore needle (P = .1). The mean numbers of complete portal tracts (CPTs) per submitted tissue per procedure were 10.0 ± 4.6 for the Quick-Core needle and 12.2 ± 6.1 for the Flexcore needle (P = .003). The mean numbers of CPTs per liver sample were 2.63 ± 1.8 for the Quick-Core needle and 3.28 ± 3.3 for the Flexcore needle (P = .00004). Complications were more common in patients with multiple comorbidities such as renal failure and coagulopathy and those who had received a liver transplant.
  
  
  CONCLUSIONS
  This study demonstrates that the 18-gauge Flexcore TJLB system provided better liver biopsy specimens compared with the 18-gauge Quick-Core needle system.
authors.affiliation: Section of Interventional Radiology, Department of Radiology and Nuclear Medicine, Rush University Medical Center, 1653 W Congress Parkway, Chicago, IL 60612, USA. george_behrens@rush.edu
authors.forename: George
authors.initials: G
authors.lastname: Behrens
authors.forename: Hector
authors.initials: H
authors.lastname: Ferral
authors.forename: Deborah
authors.initials: D
authors.lastname: Giusto
authors.forename: Jay
authors.initials: J
authors.lastname: Patel
authors.forename: David H
authors.initials: DH
authors.lastname: Van Thiel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057205:Automation, Laboratory; D001707:Biopsy, Needle / Q000009:adverse effects / Q000295:instrumentation*; D016009:Chi-Square Distribution; D002641:Chicago; D002648:Child; D004867:Equipment Design; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009339:Needles; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D055815:Young Adult