For diagnosis of liver masses, fine-needle aspiration versus needle core biopsy: which is better?

Liye Suo, Ruby Chang, Vijayalakshmi Padmanabhan, Shilpa Jain

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Introduction Both fine needle aspiration (FNA) and needle core biopsy (NCB) are widely accepted methods for obtaining diagnostic material. There is variability in how different institutions use these techniques in assessing liver masses. The aim of this study is to compare the diagnostic accuracy and tissue quality between FNA and NCB, and create a cost-effective algorithm for evaluating liver masses. Materials and methods A database search was performed to detect all liver FNA cases and their corresponding NCB between January 2014 and August 2016. A retrospective chart review was performed to gather pertinent clinicopathologic information. Results Seventy-seven FNA and 68 corresponding NCB were reviewed from 74 patients. Diagnoses in the 74 patients included 36 hepatocellular carcinomas (HCC), 29 metastatic malignancies (MET), 5 poorly differentiated carcinomas (PDC), 2 cholangiocarcinomas (CHO), and 2 benign lesions (BEN). More immunohistochemical (IHC) studies (P < 0.05) were performed on NCB tissues than FNA tissues in HCC (mean, 2.1 versus 0.8), MET (2.5 versus 0.5), and PDC groups (11.2 versus 0.2). The false negative rate (FNR) of NCB was lower (P < 0.05) than that of FNA in the HCC group; and FNR of NCB was higher (P < 0.05) than that of FNA in the MET group. Conclusions For HCC, NCB usually has better tissue quality and diagnostic accuracy than FNA; for metastatic lesions in the liver, FNA has better diagnostic accuracy than NCB, although NCB can provide more tissue for ancillary testing and has better diagnostic quality. Appropriate diagnostic method is important for improving diagnostic accuracy and saving medical resources.

Original languageEnglish
Pages (from-to)46-49
Number of pages4
JournalJournal of the American Society of Cytopathology
Issue number1
StatePublished - Jan 2018


  • Fine-needle aspiration
  • Hepatocellular carcinoma
  • Liver mass
  • Liver metastatic malignancy
  • Needle core biopsy


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