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Medical Author:

David C. Wolf, M.D., FACP, FACG, AGAF

Medical Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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The word "percutaneous" means "through the skin." Percutaneous liver biopsies are typically performed by physicians who specialize in gastroenterology/hepatology, interventional radiology or surgery. Traditionally, biopsies were performed using a "blind" technique. With this technique, the physician percusses (i.e. taps) the skin overlying the chest and abdominal wall over the liver in order to identify an optimal site for biopsy. Typically, the site is located between the 8th and 9th ribs on the patient's right side or located below the edge of the rib cage in the right upper abdomen. At present, many physicians use ultrasound to confirm the ideal site to perform the biopsy.

As noted above, the diagnosis of a mass lesion may require the performance of a so-called "guided" biopsy. In guided biopsy, the patient undergoes an ultrasound or CT scan to identify the location of the mass. The physician performing the biopsy, typically an interventional radiologist, uses the results of the scan to guide the biopsy needle into the mass. Typically, the technique for CT-guided biopsy of a mass lesion entails:

• The patient lies upon the CT table.
• An abdomen CT scan is performed to identify the location of the liver mass.
• The patient is gently sedated.
• The interventional radiologist disinfects and anesthetizes the skin over the planned biopsy site.
• The liver biopsy needle is introduced into the skin.
• When the tip of the needle is confirmed to be directed towards the mass, the actual biopsy of the mass is performed.
• The biopsy needle is removed.
• The patient is sent to the recovery room.

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