Diagnostic yield of MR-guided liver biopsies compared with CT- and US-guided liver biopsies

PURPOSE: To compare diagnostic yield and complication rates of magnetic res onance (MR)-guided versus computed tomography (CT)- and ultrasound (US)-gui ded liver biopsies. MATERIALS AND METHODS: MR-, CT-, and US-guided liver biopsies performed bet ween 9/96 and 9/98 were compared. Sixty patients (21 men and 39 women, mean age 60 years) underwent MR-guided biopsy of liver lesions, Thirty patients (16 men and 14 women, mean age 59 years) underwent CT-guided biopsy. Eight een patients (seven men and 11. women, mean age 50 years) underwent US-guid ed biopsy, MR procedures were performed in an open-configuration 0.5-T Sigm a SP MR unit. Lesion localization used standard T1 and T2 sequences, wherea s biopsies were performed with multiplanar spoiled gradient recalled echo a nd fast gradient recalled echo sequences, A coaxial system with an MB-compa tible 18-gauge stabilizing needle and a 21-gauge aspiration needle was used to obtain all samples. In CT and US procedures, a 19-gauge stabilizing nee dle and a 21-gauge aspiration or a 20-gauge core biopsy needle were used. A cytotechnologist was present to determine the adequacy of samples. RESULTS: MR had a diagnostic yield of 61%, CT and US had diagnostic yields of 67% and 61%, respectively. No serious complications were reported for MR and US procedures. Two CT biopsies resulted in postprocedural hemorrhage, One patient required surgical exploration and died. CONCLUSIONS: MR-guided biopsy of liver lesions with use of a 0.5-T open-con figuration magnet is safe and accurate when compared with CT and US, No sta tistical difference was observed between the diagnostic yield of biopsies p erformed with MR, CT, and US guidance. MR. enabled biopsy of a number of le sions in the hepatic dome and lesions with low contrast, which would normal ly be difficult to sample safely with use of CT or US.