Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000068.xml
Download PDF
Semin intervent Radiol 2025; 42(02): 244-250
DOI: 10.1055/s-0045-1806737
DOI: 10.1055/s-0045-1806737
How I Do It
Nontargeted Liver Biopsy in Children
In 1960, Hong and Schubert reported a case series of percutaneous liver biopsies in children using the Menghini needle.[1] Since that time and despite advances in noninvasive diagnostic measures, liver biopsy (LB) retains an important role in the evaluation of children with liver disease.[2] Traditionally, pediatric liver biopsies were performed by pediatric gastroenterologists without imaging guidance. Today, most liver biopsies in children are performed by interventional radiologists with imaging guidance.[3] This article reviews nontargeted LB in children, both percutaneous and transjugular, with attention to technical considerations for the interventional radiologist.
Publication History
Article published online:
26 March 2025
© 2025. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Hong R, Schubert WK. Menghini needle biopsy of the liver. Am J Dis Child 1960; 100: 42-46
- 2 Ovchinsky N, Moreira RK, Lefkowitch JH, Lavine JE. Liver biopsy in modern clinical practice: a pediatric point-of-view. Adv Anat Pathol 2012; 19 (04) 250-262
- 3 Potter C, Hogan MJ, Henry-Kendjorsky K, Balint J, Barnard JA. Safety of pediatric percutaneous liver biopsy performed by interventional radiologists. J Pediatr Gastroenterol Nutr 2011; 53 (02) 202-206
- 4 Adnan A, Sheth RA. Image-guided percutaneous biopsy of the liver. Tech Vasc Interv Radiol 2021; 24 (04) 100773
- 5 Dezsőfi A, Baumann U, Dhawan A. et al; ESPGHAN Hepatology Committee. Liver biopsy in children: position paper of the ESPGHAN Hepatology Committee. J Pediatr Gastroenterol Nutr 2015; 60 (03) 408-420
- 6 Sheth RA, Baerlocher MO, Connolly BL. et al. Society of Interventional Radiology quality improvement standards on percutaneous needle biopsy in adult and pediatric patients. J Vasc Interv Radiol 2020; 31 (11) 1840-1848
- 7 Tublin ME, Blair R, Martin J, Malik S, Ruppert K, Demetris A. Prospective study of the impact of liver biopsy core size on specimen adequacy and procedural complications. AJR Am J Roentgenol 2018; 210 (01) 183-188
- 8 Govender P, Jonas MM, Alomari AI. et al. Sonography-guided percutaneous liver biopsies in children. AJR Am J Roentgenol 2013; 201 (03) 645-650
- 9 Hebelka H, de Lange C, Boström H, Ekvall N, Lagerstrand K. Shear wave elastography in the differentiation of nonfibrotic versus fibrotic liver disease in children: a prospective study with histological correlation. JPGN Rep 2021; 3 (01) e156
- 10 Borquez AA, Silva-Sepulveda J, Lee JW. et al. Transjugular liver biopsy for Fontan associated liver disease surveillance: technique, outcomes and hemodynamic correlation. Int J Cardiol 2021; 328: 83-88
- 11 Perito ER, Martinez M, Turmelle YP. et al. Posttransplant biopsy risk for stable long-term pediatric liver transplant recipients: 451 percutaneous biopsies from two multicenter immunosuppression withdrawal trials. Am J Transplant 2019; 19 (05) 1545-1551
- 12 Tapper EB, Lok AS. Use of liver imaging and biopsy in clinical practice. N Engl J Med 2017; 377 (08) 756-768
- 13 Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. American Association for the Study of Liver Diseases. Liver biopsy. Hepatology 2009; 49 (03) 1017-1044
- 14 Salamo RM, Miller J. Quick, safe, effective: ultrasound-guided percutaneous liver biopsy in the pediatric patient. Cardiovasc Intervent Radiol 2024; 47 (01) 87-91
- 15 Midia M, Odedra D, Shuster A, Midia R, Muir J. Predictors of bleeding complications following percutaneous image-guided liver biopsy: a scoping review. Diagn Interv Radiol 2019; 25 (01) 71-80
- 16 Nobili V, Comparcola D, Sartorelli MR. et al. Blind and ultrasound-guided percutaneous liver biopsy in children. Pediatr Radiol 2003; 33 (11) 772-775
- 17 Short SS, Papillon S, Hunter CJ. et al. Percutaneous liver biopsy: pathologic diagnosis and complications in children. J Pediatr Gastroenterol Nutr 2013; 57 (05) 644-648
- 18 Patel IJ, Rahim S, Davidson JC. et al. Society of Interventional Radiology Consensus Guidelines for the periprocedural management of thrombotic and bleeding risk in patients undergoing percutaneous image-guided interventions - Part II: Recommendations: endorsed by the Canadian Association for Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe. J Vasc Interv Radiol 2019; 30 (08) 1168-1184.e1
- 19 Little AF, Ferris JV, Dodd III GD, Baron RL. Image-guided percutaneous hepatic biopsy: effect of ascites on the complication rate. Radiology 1996; 199 (01) 79-83
- 20 Murphy FB, Barefield KP, Steinberg HV, Bernardino ME. CT- or sonography-guided biopsy of the liver in the presence of ascites: frequency of complications. AJR Am J Roentgenol 1988; 151 (03) 485-486
- 21 Neuberger J, Patel J, Caldwell H. et al. Guidelines on the use of liver biopsy in clinical practice from the British Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology. Gut 2020; 69 (08) 1382-1403
- 22 Willis J, Carroll C, Planz V, Galgano SJ. Thromboelastography: a review for radiologists and implications on periprocedural bleeding risk. Abdom Radiol (NY) 2022; 47 (08) 2697-2703
- 23 Wong K, Wadhwa V, Ferguson K. et al. Potential utility of thromboelastography for patients with abnormal coagulation markers in interventional radiology: report of 3 cases and review of literature. Cardiovasc Intervent Radiol 2021; 44 (06) 996-998
- 24 Smayra K, Miangul S, Yap N. et al. Technical success, sample adequacy, and complications of pediatric transjugular liver biopsy: a systematic review and meta-analysis. Dig Dis Sci 2023; 68 (10) 3846-3856
- 25 Chehab MA, Thakor AS, Tulin-Silver S. et al. Adult and pediatric antibiotic prophylaxis during vascular and IR procedures: a Society of Interventional Radiology Practice Parameter Update Endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Association for Interventional Radiology. J Vasc Interv Radiol 2018; 29 (11) 1483-1501.e2
- 26 Matos H, Noruegas MJ, Gonçalves I, Sanches C. Effectiveness and safety of ultrasound-guided percutaneous liver biopsy in children. Pediatr Radiol 2012; 42 (11) 1322-1325
- 27 Sornsakrin M, Helmke K, Briem-Richter A, Ganschow R. Value of ultrasound-guided percutaneous liver biopsy in children following liver transplantation. J Pediatr Gastroenterol Nutr 2010; 51 (05) 635-637
- 28 Jing H, Xu R, Qian L. et al. Prospective comparison of an 18-gauge versus 16-gauge needle for percutaneous liver core-needle biopsy in children. Abdom Radiol (NY) 2024; 49 (02) 604-610
- 29 Pietrobattista A, Fruwirth R, Natali G, Monti L, Devito R, Nobili V. Is juvenile liver biopsy unsafe? Putting an end to a common misapprehension. Pediatr Radiol 2009; 39 (09) 959-961
- 30 McDonald J, Amirabadi A, Farhat Z. et al. Experience with compressed Gelfoam plugs in children during liver biopsies and other IR procedures: a retrospective single-center case series. J Vasc Interv Radiol 2019; 30 (11) 1855-1862
- 31 Reis J, Koo KSH, Shivaram GM, Shaw DW, Monroe EJ. Safety of periprocedural antithrombotics during pediatric transplant liver biopsies. J Vasc Interv Radiol 2023; 34 (03) 460-465
- 32 Tulin-Silver S, Obi C, Kothary N, Lungren MP. Comparison of transjugular liver biopsy and percutaneous liver biopsy with tract embolization in pediatric patients. J Pediatr Gastroenterol Nutr 2018; 67 (02) 180-184
- 33 Lungren MP, Lindquester WS, Seidel FG. et al. Ultrasound-guided liver biopsy with gelatin sponge pledget tract embolization in infants weighing less than 10 kg. J Pediatr Gastroenterol Nutr 2016; 63 (06) e147-e151
- 34 Atar E, Ben Ari Z, Bachar GN. et al. A comparison of transjugular and plugged-percutaneous liver biopsy in patients with contraindications to ordinary percutaneous liver biopsy and an “in-house” protocol for selecting the procedure of choice. Cardiovasc Intervent Radiol 2010; 33 (03) 560-564
- 35 Bolia R, Matta J, Malik R, Hardikar W. Outpatient liver biopsy in children: safety, feasibility, and economic impact. J Pediatr Gastroenterol Nutr 2017; 65 (01) 86-88
- 36 Riddle C, Ahmed B, Doyle J, Connolly BL. Migration of Gelfoam to the gallbladder after liver biopsy. Pediatr Radiol 2008; 38 (07) 806-809
- 37 Westheim BH, Aagenæs I, Østensen AB, Sanengen T, Almaas R. Effect of operator experience and frequency of procedure performance on complication rate after ultrasound-guided percutaneous liver biopsies. J Pediatr Gastroenterol Nutr 2013; 57 (05) 638-643
- 38 Alomari MH, Kerr CL, Chewning R. et al. Two-hour observation after liver biopsy in children: clinical and economic outcome of a quality improvement intervention. J Pediatr Gastroenterol Nutr 2020; 71 (04) e105-e108
- 39 Westheim BH, Østensen AB, Aagenæs I, Sanengen T, Almaas R. Evaluation of risk factors for bleeding after liver biopsy in children. J Pediatr Gastroenterol Nutr 2012; 55 (01) 82-87
- 40 Amaral JG, Schwartz J, Chait P. et al. Sonographically guided percutaneous liver biopsy in infants: a retrospective review. AJR Am J Roentgenol 2006; 187 (06) W644-9
- 41 Hoffer FA. Liver biopsy methods for pediatric oncology patients. Pediatr Radiol 2000; 30 (07) 481-488
- 42 Bilreiro C, Noruegas MJ, Gonçalves I, Moreira Â. Ultrasound-guided liver biopsies in children: a single-center experience and risk factors for minor bleeding. J Pediatr Gastroenterol Nutr 2017; 65 (02) 137-140
- 43 Bjorklund A, Resch J, Slusher T. Pediatric shock review. Pediatr Rev 2023; 44 (10) 551-565
- 44 Habdank K, Restrepo R, Ng V. et al. Combined sonographic and fluoroscopic guidance during transjugular hepatic biopsies performed in children: a retrospective study of 74 biopsies. AJR Am J Roentgenol 2003; 180 (05) 1393-1398
- 45 Behrens G, Ferral H. Transjugular liver biopsy. Semin Intervent Radiol 2012; 29 (02) 111-117
- 46 Sue MJ, Lee EW, Saab S. et al. Transjugular liver biopsy: safe even in patients with severe coagulopathies and multiple biopsies. Clin Transl Gastroenterol 2019; 10 (07) e00063
- 47 Bergey EA, Sane SS, Kaye RD, Redd DC, Towbin RB. Pediatric transvenous liver biopsy. J Vasc Interv Radiol 1998; 9 (05) 829-832
- 48 Smith TP, Presson TL, Heneghan MA, Ryan JM. Transjugular biopsy of the liver in pediatric and adult patients using an 18-gauge automated core biopsy needle: a retrospective review of 410 consecutive procedures. AJR Am J Roentgenol 2003; 180 (01) 167-172
- 49 Shahid MU, Frenkel Y, Kuc N, Golowa Y, Cynamon J. Transfemoral-transcaval liver biopsy (TFTC) and transjugular liver biopsy (TJLB) in patients with Fontan-associated liver disease (FALD). Cardiovasc Intervent Radiol 2024; 47 (07) 875-882
- 50 Tran DK, Ko GY, Sung KB, Gwon DI. Transjugular liver biopsy following left lobe or lateral segment transplantation in pediatric patients. Cardiovasc Intervent Radiol 2019; 42 (11) 1545-1550
- 51 Miraglia R, Maruzzelli L, Spada M, Riva S, Luca A, Gridelli B. Transjugular liver biopsy in pediatric patients with left split liver transplantation and severe coagulation impairment. Pediatr Transplant 2012; 16 (01) 58-62
- 52 Kaufman CS, Cretcher MR. Transjugular liver biopsy. Tech Vasc Interv Radiol 2021; 24 (04) 100795
- 53 Sebastian B, Singhal S, Botcha S, Madhurkar R, Thiruchunapalli D, Uthappa MC. The utility of ultrasound guidance in transjugular liver biopsy: our experience. Abdom Radiol (NY) 2019; 44 (02) 749-755
- 54 Kalambokis G, Manousou P, Vibhakorn S. et al. Transjugular liver biopsy -- indications, adequacy, quality of specimens, and complications -- a systematic review. J Hepatol 2007; 47 (02) 284-294