Blinded comparison of biopsy needles and automated devices in vitro: 1. Biopsy of diffuse hepatic disease

OBJECTIVE. The purpose of this study was to compare several of the commonly used needles with several of the new automated biopsy devices (biopsy guns) for biopsy of diffuse hepatic disease. MATERIALS AND METHODS. Nine different biopsy needles or automated devices were each used to do three biopsies of 10 cadaveric livers. The specimens were reviewed in a blinded fashion by a pathologist who did not know which needle or device was used, and they were compared on the basis of a previously published histopathologic grading scale. RESULTS. The three conventional biopsy needles (16-gauge Jamshidi, 18-gauge Sure-Cut, and 14-gauge Tru-Cut) obtained a large amount of tissue with an average of 4.1 intact portal triads per biopsy. The 18-gauge Biopsy gun obtained equivalent results. The 18-gauge Autovac gun with a 2-cm biopsy depth did not obtain any tissue in 18.5% of attempts. The 14- and 16- gauge Biopsy guns and the 18-gauge Autovac gun with a 4-cm biopsy depth performed best with respect to fragment size and number of intact portal triads. CONCLUSION. Automated biopsy devices can provide more diagnostic specimens than can manual or conventional needles in biopsy for diffuse hepatic disease.