CT-guided diagnostic interventions for classification of focal hepatic lesions: A comparison of 14 G- and 18 G-large bore cutting needles.

Purpose: Analysis and comparison of CT-guided 14- and 18-gauge cutting need le biopsies to accurately assess focal liver disease. Methods: The data of 272 CT-guided biopsies in 268 patients were evaluated retrospectively with regard to sensitivity, specificity and complication rate of the chosen need le caliber in differentiating between benign and malignant disease as well as in the ability to determine specific cell types in the various disorders . A 14-gauge (G) needle was used in 101 (37.1%) cases, an 18-g needle biops y was performed in 171 (62.9%) cases. The Fisher exact test was employed fo r statistical analysis. Results: Cutting needle biopsy yielded sufficient h istologic material in 267 of 272 (98.2%) cases. Correct diagnosis of malign ancy was established in 178 of 191 (93.2%) lesions, 73 of 76 (96.1%) disord ers were accurately defined as benign, resulting in an overall value of 940 % (251 of 267). Of these 251 biopsies a definite histological diagnosis cou ld be determined in 90.6% of the cases employing a 14 G needle and in 90.3% using an 18-g needle. The sensitivity, specificity and rate of complicatio ns were 94.8%, 92.0%, 3.0% for the 14-g needle and 92.7%, 97.6%, 0.6% for t he 18-g needle, respectively. There were no statistically significant diffe rences with regard to the needle size. Conclusions: CT-guided biopsy of hep atic lesions with the 18-g biopsy needle is of equivalent diagnostic accura cy when compared with the 14-g needle.