Role of endoscopic ultrasound-guided liver biopsy: a meta-analysis

Abstract

Background

Endoscopic ultrasound-guided liver biopsy (EUS-LB) is an evolving technique. In this meta-analysis, we aimed to evaluate the value of EUS-LB for parenchymal and focal liver lesions. Besides, we aimed to assess the influences of needle-related factors on the performance of EUS-LB. Additionally, we aimed to assess the influence of various criteria on specimen adequacy.

Methods

We searched the PubMed, Embase, Cochrane Library databases up to 10 October 2021. The primary outcome was diagnostic yield, specimen adequacy, qualified specimens evaluated by rapid on-site evaluation (ROSE). The secondary outcome was adverse events. Subgroup analyses were based on needle type, needle size, fine-needle biopsy (FNB) needle type. A sensitivity analysis was conducted on specimen adequacy based on two definition criteria.

Results

In total, 33 studies were included. Pooled rates of diagnostic yield, specimen adequacy, qualified specimen by ROSE, adverse events were 95%, 84%, 93%, 3%. Subgroup analyses showed that Acquire needles generated higher diagnostic yield than SharkCore needles (99% vs. 88%, p = .047). Additionally, FNB needles demonstrated a higher rate of adverse events than FNA needles (6% vs. 1%, p = .028). Sensitivity analysis on specimen adequacy based on various criteria demonstrated that the specimen adequacy rate defined by the AASLD criterion was lower than that of the commonly-used criterion (37% vs. 84%, p = .001).

Conclusion

EUS-LB is effective and safe for liver biopsy. Acquire needles provide better specimens than SharkCore needles. FNB needles may increase the risk of adverse events compared with FNA needles. The AASLD criterion is harder to achieve than the commonly-used criterion.

Keywords:

• Endoscopic ultrasound
• liver biopsy
• liver parenchymal diseases
• focal liver lesions
• meta-analysis

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Author contributions

Qiang Lu and Kefei Chen conceived the study and designed the protocol. Zhenpeng Jiang performed the literature search. Keyu Zeng and Jie Yang selected the studies and extracted relevant information. Keyu Zeng, Zhenpeng Jiang and Jie Yang conducted the data synthesis. Keyu Zeng wrote the first version of the draft. Qiang Lu critically revised successive drafts of the paper and approved the final version.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This paper is not funded.