TY - JOUR
T1 - EUS-guided core liver biopsy sampling using a 22-gauge fork-tip needle
T2 - a prospective blinded trial for histologic and lipidomic evaluation in nonalcoholic fatty liver disease
AU - Bazerbachi, Fateh
AU - Vargas, Eric J.
AU - Matar, Reem
AU - Storm, Andrew C.
AU - Mounajjed, Taofic M.
AU - Topazian, Mark D.
AU - Levy, Michael J.
AU - Chandrasekhara, Vinay
AU - Abu Dayyeh, Barham K.
N1 - Publisher Copyright:
© 2019 American Society for Gastrointestinal Endoscopy
PY - 2019/12
Y1 - 2019/12
N2 - Background and Aims: Diagnostic tools for nonalcoholic fatty liver disease (NAFLD) detection and prognostication are limited, with histology remaining the criterion standard. We evaluated the feasibility and safety of EUS-guided liver biopsy (EUS-LB) sampling in NAFLD staging. Methods: In a prospective cohort of NAFLD patients with steatohepatitis and early liver fibrosis based on magnetic resonance elastography (MRE), EUS-LB sampling procedures were performed using a 22-gauge fork-tip core biopsy needle. Samples were evaluated by a blinded pathologist. Total aggregate sample length (TASL), number of complete portal triads, ability to calculate NAFLD activity score, ability to stage liver fibrosis, and ability to provide enough core liver tissue for lipidomics analysis were evaluated. Performance of EUS-LB sampling was compared with MRE. Results: Forty-one EUS-LB samples were obtained. The median TASL was 2.4 cm (interquartile range, 2.00-2.75). The median number of complete portal triads per TASL was 26 (interquartile range, 7-62). Of the samples, 100% were adequate to convey NAFLD activity score and fibrosis stage. All samples provided enough core liver tissue to allow the application of lipidomics testing. A significant positive linear association between EUS-LB sampling–detected fibrosis and MRE-detected fibrosis was observed (r = .469, P < .005). Compared with MRE, EUS-LB sampling established early fibrosis in 13 cases that MRE classified as normal. EUS-LB sampling–related adverse events occurred in 7% and were restricted to postprocedural pain. Conclusions: EUS-LB sampling is a viable technique for full NAFLD evaluation and may be superior to MRE in establishing the diagnosis of nonalcoholic steatohepatitis with early fibrosis. (Clinical trial registration number: NCT02880189.)
AB - Background and Aims: Diagnostic tools for nonalcoholic fatty liver disease (NAFLD) detection and prognostication are limited, with histology remaining the criterion standard. We evaluated the feasibility and safety of EUS-guided liver biopsy (EUS-LB) sampling in NAFLD staging. Methods: In a prospective cohort of NAFLD patients with steatohepatitis and early liver fibrosis based on magnetic resonance elastography (MRE), EUS-LB sampling procedures were performed using a 22-gauge fork-tip core biopsy needle. Samples were evaluated by a blinded pathologist. Total aggregate sample length (TASL), number of complete portal triads, ability to calculate NAFLD activity score, ability to stage liver fibrosis, and ability to provide enough core liver tissue for lipidomics analysis were evaluated. Performance of EUS-LB sampling was compared with MRE. Results: Forty-one EUS-LB samples were obtained. The median TASL was 2.4 cm (interquartile range, 2.00-2.75). The median number of complete portal triads per TASL was 26 (interquartile range, 7-62). Of the samples, 100% were adequate to convey NAFLD activity score and fibrosis stage. All samples provided enough core liver tissue to allow the application of lipidomics testing. A significant positive linear association between EUS-LB sampling–detected fibrosis and MRE-detected fibrosis was observed (r = .469, P < .005). Compared with MRE, EUS-LB sampling established early fibrosis in 13 cases that MRE classified as normal. EUS-LB sampling–related adverse events occurred in 7% and were restricted to postprocedural pain. Conclusions: EUS-LB sampling is a viable technique for full NAFLD evaluation and may be superior to MRE in establishing the diagnosis of nonalcoholic steatohepatitis with early fibrosis. (Clinical trial registration number: NCT02880189.)
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U2 - 10.1016/j.gie.2019.08.006
DO - 10.1016/j.gie.2019.08.006
M3 - Article
C2 - 31437454
AN - SCOPUS:85073024046
SN - 0016-5107
VL - 90
SP - 926
EP - 932
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 6
ER -