Feasibility and safety of endoscopic ultrasound-guided liver biopsy to diagnose parenchymal liver disease: A multi-centre retrospective cohort study

Table 1 Baseline patient and procedural characteristics (n = 50), n (%)

Variable	Overall (n = 50)	FNA (n = 26)	FNB (n = 24)	P value
Gender
Male	20 (40.0)	13 (50.0)	7 (29.2)	0.13
Female	30 (60.0)	13 (50.0)	17 (70.8)
Age, mean (SD)	43.9 (15.5)	43.3 (15.6)	44.7 (15.7)	0.75
Sedation
Conscious sedation	47 (94.0)	26 (100)	21 (87.5)	0.06
General anesthesia	3 (6.0)	0 (0)	3 (12.5)
Needle type
FNA	26 (52.0)	NA	NA	NA
FNB	24 (48.0)
Number of needle passes, median (range)	3 (2-5)	4 (3-5)	2 (2-5)	< 0.0001
Liver lobe biopsied
Left lobe	48 (96.0)	25 (96.2)	23 (95.8)	0.95
Right lobe	0 (0)	0 (0)	0 (0)
Both lobes	2 (4.0)	1 (3.8)	2 (4.2)
Aspiration technique
No suction	25 (50.0)	21 (80.8)	4 (16.7)	< 0.0001
Wet heparin suction	25 (40.0)	5 (19.2)	20 (83.3)

FNB: Fine needle biopsy; FNA: Fine needle aspiration.

Table 2 Primary and secondary outcomes, n (%)

Variable	Overall	FNA	FNB	P value
Diagnostic adequacy
Yes	43 (86.0)	22 (84.6)	21 (87.5)
No	7 (14.0)	4 (15.4)	3 (12.5)	0.77
Final histopathological diagnosis
MASLD	16 (32.0)	8 (30.8)	8 (33.3)	0.94
DILI	12 (24.0)	6 (23.1)	6 (25.0)
Hemosiderosis	2 (4.0)	1 (3.8)	1 (4.2)
AIH	5 (10.0)	3 (11.5)	2 (8.3)
PBC	3 (6.0)	1 (3.8)	2 (8.3)
PSC	1 (2.0)	1 (3.8)	0 (0)
Acute cellular rejection	1 (2.0)	0 (0)	1 (4.2)
Cholestasis	2 (4.0)	1 (3.8)	1 (4.2)
Sarcoid	1 (2.0)	1 (3.8)	0 (0)
Non-diagnostic	7 (14.0)	4 (15.4)	3 (12.5)
Complications	1 (2.0)	0 (0)	1 (4.2)	0.29
Post procedure pain	5 (10.0)	2 (7.7)	3 (12.5)	0.57
Fulfills EASL criteria
Yes	27 (54.0)	7 (26.9)	20 (83.3)	< 0.0001
No	23 (46.0)	19 (73.1)	4 (16.7)
Fulfills AASLD criteria
Yes	17 (34.0)	2 (7.7)	15 (62.5)	< 0.0001
No	33 (66.0)	24 (92.3)	9 (37.5)
Number of complete portal triads, mean (SD)	17.1 (14.6)	10.6 (9.6)	24.1 (15.9)	0.0006
Length of longest specimen (mm), mean (SD)	8.1 (8.0)	2.2 (0.80)	14.6 (8.4)	< 0.0001
Total specimen length (mm), mean (SD)	24.2 (23.8)	9.4 (6.4)	40.3 (25.4)	< 0.0001

AIH: Autoimmune hepatitis; DILI: Drug-induced liver injury; MASLD: Metabolic dysfunction-associated steatotic liver disease; PBC: Primary biliary cholangitis; PSC: Primary sclerosing cholangitis; FNB: Fine needle biopsy; FNA: Fine needle aspiration; EASL: European Association for the Study of Liver; AASLD: American Association for the Study of Liver Diseases.

Table 3 Multivariate logistic regression analysis of predictors of optimal diagnostic adequacy (adjusted for age and gender)

Variable	Adjusted odds ratio	95% confidence intervals	P value
Use of FNB needle	1.2	0.2-6.5	0.24
Use of wet heparin suction	1.4	0.3-7.6	0.67
Performing > 2 passes	1.22	0.22-6.92	0.82

FNB: Fine needle biopsy.

Table 4 Multivariate logistic regression analysis of predictors of optimal histopathological specimen according to European Association for the Study of Liver criteria (adjusted for age and gender)

Variable	Adjusted odds ratio	95% confidence intervals	P value
Use of FNB needle	19.9	4.2-94.2	< 0.0001
Use of wet heparin suction	7.8	2.1-29.1	0.002
Performing > 2 passes	0.10	0.02-0.47	0.003

FNB: Fine needle biopsy.

Table 5 Multivariate logistic regression analysis of predictors of optimal histopathological specimen according to American Association for the Study of Liver Diseases criteria (adjusted for age and gender)

Variable	Adjusted odds ratio	95% confidence intervals	P value
Use of FNB needle	19.9	3.6-108.6	0.001
Use of wet heparin suction	42.9	4.7-388.1	0.001
Performing > 2 passes	0.13	0.03-0.54	0.005

FNB: Fine needle biopsy.