Biopsy of focal lesions of the liver necessary - Useful - or waste of time?

Despite significant progress in non-invasive new radiological imaging techniques, a precise diagnosis of focal liver lesions remains difficult and therefore requires a biopsy of the presumed liver tumour. Liver biopsy results are most useful when the biopsy is performed for well defined indications at an early stage during the diagnostic procedure. In case of lesions highly suspicious for HCC, a biopsy should be performed in case of other than surgical (curative) treatment. Planning a surgical intervention, biopsy of the tumour is not necessary. In case of concomitant liver cirrhosis, a biopsy taken from non-neoplastic cirrhotic liver areas may help in assessing the functional capacity. Metastases of the liver with unknown primary tumour should be biopsied to get data of the location of the primary tumour. Concern has been expressed over the years about seeding of the needle tract with malignant cells. Indeed, such instances have been recorded with various carcinomas, but they are rare events and seldom of clinical importance. In conclusion, liver biopsy is an effective and useful procedure in the diagnosis of liver lesions and provides significant information for subsequent patient care.