Performance of manual versus automated device assisted liver biopsy

Document Type





Objective: To assess the performance of manual and automated biopsy device (Bard Magnum) -assisted biopsy methods in terms of specimen adequacy, procedure time, number of passes and complications.
Methods: The study was conducted at the Sarwar Zuberi Liver Centre and the Department of Radiology of Civil Hospital and Dow university of Health Sciences, Karachi from September 2007 to September 2010. All adult patients undergoing liver biopsy under ultrasound guidance with standard technique were included. 18-G cutting edge needles were for both the manual biopsy as well as the automated biopsy device. Studied variables were sample adequacy, procedural time, number of passes per procedure, complications and need for post procedural analgesia. Chi square and t-test were used for comparing the proportions and mean values respectively between the two groups, with significance at p<0.05.
Results: A total of 405 biopsies were performed: 174 manually and 285 with automated device- assistance. Adequate sample was obtained in 98.2% by the former and 100% in the latter. Majority specimen was obtained in single pass by either method. Sample size was adequate in both but fragmentation was significantly more common with manual biopsy. Assisted device was complicated by hypotension in one case only. Two cases of hypotension and one case each of hematoma formation and vaso vagal syncope was observed in manual method. Procedure time was significantly shorter on using device (3.6 vs. 8.40 minutes, p<0.05). Need for post procedural analgesia was not markedly different.
Conclusion: There was no significant difference between the performances of the two techniques except for shorter time in automated device- assisted method and more fragmentation of sample by manual biopsy.

Publication (Name of Journal)

Pakistan Journal of Radiology