246 Background: Percutaneous biopsy of suspected liver metastases is a common practice for diagnostic purposes. Particularly, in the setting of oncological clinical trials, it is a relatively non-invasive method to obtain sufficient tissue for molecular analyses at regular set time points. However, various complications may occur, including seeding of the tumour along the biopsy tract. Only few reports exist on the actual incidence of seeding, on a limited number of tumor types. The aim of this study was to evaluate the technique’s safety and risk of seeding. Methods: All patients with an ultrasound or CT-guided liver biopsy between 2012-2016 were included. Medical records were reviewed retrospectively for post-biopsy complications and all follow-up imaging was re-assessed for the presence of seeding, defined as tumoral deposits in the biopsy needle tract. Results: In total 782 biopsies were performed in 550 patients (282 women, 268 men; mean age of 61 years), 43.9% (343/782) for trials and 56.1% (439/782) for diagnostic/molecular purposes, 93.7% (733/782) were diagnostic, revealing malignancy in 96.9% (710/733). Number of biopsies per patient ranged between 1 (n=387) to 7 (n=1), a co-axial system was used in 70.6% (552/782) and multiple passes in 29.4% (230/782). Complications were reported in 8.8% (69/782), more often pain (4.7%) and hypotension/vasovagal (2.3%). Admission and/or re-intervention were needed for more severe complications as bleeding (1.0%), sepsis/fever (1.1%), pulmonary embolism (0.3%) and pneumothorax (0.4%). Seeding was seen in 1.1% (8/782) of cases (2/44 melanoma, 1/11 GIST, 1/39 cholangiocarcinoma, 1/247 colorectal, 1/14 oesophagus, 1/97 breast, 1/31 prostate). Mean time for seeding was 208 days (range 43-469 d); mean post-biopsy survival time was 495 days in the seeding and 349 days in the non-seeding group. Conclusions: Percutaneous liver biopsy is a highly effective and safe method for tissue collection, with only a minimal risk of seeding.
Abstract No. 206 Comparing the safety and efficacy of ultrasound-guided random percutaneous liver biopsy: right versus left hepatic lobe approaches
