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BACKGROUND: Ultrasound-guided percutaneous liver biopsy is a standard procedure, but it might be burdened with serious adverse events, mainly hemorrhagic. Literature lacks recent studies taking into account new ultrasound machines, more sensitive to tiny vessels and the evolution of the bioptic technique, including ultrasound guidance in all instances. Hence, the primary aim of this study was to evaluate complication rates of ultrasound-guided percutaneous liver biopsy in a recent population. Secondary aims were to evaluate if the experience of operator is a determinant of risk of complication and to identify other potential risk factors. METHODS: We evaluated 800 procedures carried out in one hospital in the period 2010-2018. RESULTS: Complication rate resulted in 4%, with the occurrence of moderate hemorrhagic complications in 0.75%. No cases of severe events or death were registered. A higher risk of bleeding was found to be associated with less experienced operators, while the need to perform multiple needle insertions increased the probability of adverse events. CONCLUSION: The present findings confirmed ultrasound-guided percutaneous liver biopsy to be a substantially safe procedure with a low risk of overall adverse events and bleeding in particular, especially when performed by expert operators.

Purpose: Different shear wave elastography (SWE) machines able to quantify liver stiffness (LS) have been recently introduced by various companies. The aim of this study was to investigate the agreement between point SWE with Esaote MyLab Twice (pSWE.ESA) and 2D SWE with Aixplorer SuperSonic (2D SWE.SSI). Moreover, we assessed the correlation of these machines with Fibroscan in a subgroup of patients. Methods: A total of 81 liver disease patients and 27 subjects without liver disease accessing the ultrasound lab were considered. Exclusion criteria were liver nodules, BMI >35, and severe comorbidities. LS was sampled from the same intercostal space with both pSWE.ESA and 2D SWE.SSI and values were tested with Lin’s analysis and Bland–Altman analysis (B&A). Agreement between each SWE machine and Fibroscan was assessed in 26 liver disease patients with Spearman correlation. Results: Precision and accuracy between pSWE.ESA and 2D SWE.SSI were, respectively, 0.839 and 0.999. B&A showed a mean of only −0.2 kPa, with no systematic deviation between the techniques and limits of agreement at −11.6 and 11.3 kPa. Spearman’s rho correlation versus Fibroscan was 0.849 for pSWE.ESA and 0.878 for 2D SWE.SSI. The relationship became less strict in the higher range of LS (≥15.2 kPa), corresponding to cirrhosis. Conclusion: The overall degree of concordance of pSWE.ESA and 2D SWE.SSI in measuring LS resulted remarkable, also when compared with Fibroscan. The less strict correlation for patients with LS in the higher range would not affect the staging of disease as such patients are anyhow classified as cirrhotic.

Different shear wave elastography (SWE) machines able to quantify liver stiffness (LS) have been recently introduced by various companies. The aim of this study was to investigate the agreement between point SWE with Esaote MyLab Twice (pSWE.ESA) and 2D SWE with Aixplorer SuperSonic (2D SWE.SSI). Moreover, we assessed the correlation of these machines with Fibroscan in a subgroup of patients.A total of 81 liver disease patients and 27 subjects without liver disease accessing the ultrasound lab were considered. Exclusion criteria were liver nodules, BMI35, and severe comorbidities. LS was sampled from the same intercostal space with both pSWE.ESA and 2D SWE.SSI and values were tested with Lin's analysis and Bland-Altman analysis (BA). Agreement between each SWE machine and Fibroscan was assessed in 26 liver disease patients with Spearman correlation.Precision and accuracy between pSWE.ESA and 2D SWE.SSI were, respectively, 0.839 and 0.999. BA showed a mean of only -0.2 kPa, with no systematic deviation between the techniques and limits of agreement at -11.6 and 11.3 kPa. Spearman's rho correlation versus Fibroscan was 0.849 for pSWE.ESA and 0.878 for 2D SWE.SSI. The relationship became less strict in the higher range of LS (≥15.2 kPa), corresponding to cirrhosis.The overall degree of concordance of pSWE.ESA and 2D SWE.SSI in measuring LS resulted remarkable, also when compared with Fibroscan. The less strict correlation for patients with LS in the higher range would not affect the staging of disease as such patients are anyhow classified as cirrhotic.Differenti metodiche di shear wave elastography (SWE) in grado di misurare la rigidità epatica (RE) sono state recentemente implementate su vari ecografi. Questo studio vuole valutare la concordanza fra Esaote MyLab Twice point SWE (pSWE.ESA) e Aixplorer SuperSonic 2DSWE (2DSWE.SSI). Inoltre si è potuto anche valutare la correlazione fra queste macchine e il Fibroscan in un sottogruppo di pazienti.Sono stati arruolati 81 pazienti con epatopatia cronica e 27 soggetti con fegato sano afferenti al laboratorio di ecografia. Sono stati esclusi pazienti con lesioni focali epatiche, BMI35 kg/mPrecisione ed accuratezza sono risultate rispettivamente 0.839 e 0.999. L’analisi di BA ha mostrato uno scarto medio di soli −0.2 kPa e limiti di concordanza a −11.6 e 11.3 kPa, senza rilevare alcuna deviazione sistematica fra le due macchine. Il coefficiente di correlazione con il Fibroscan è risultato 0.849 per pSWE.ESA e 0.878 per 2D SWE.SSI. Si è osservata una lieve deflessione del coefficiente di concordanza tra le due metodiche per alti valori di RE (all’interno della classe corrispondente alla cirrosi).La concordanza fra pSWE.ESA e 2DSWE.SSI è risultata globalmente elevata, anche nel confronto con il Fibroscan. La stadiazione dell’epatopatia non viene compromessa dal calo di correlazione ai valori più alti di RE, in quanto tali pazienti verrebbero comunque classificati come cirrotici.