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Diagnosis of Metastatic Liver Cancer

Kenneth L. Jewel, MD
JAMA. 1984;251(2):216. doi:10.1001/jama.1984.03340260024013.
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To the Editor.—  In a letter by Dr Silberstein1 concerning the study by Tempero et al,2 the author states that the sensitivity of multiple liver biopsies averages 70% and does not exceed 82%.I would like to take exception to these statistical figures. In our institution, more than 250 image-guided percutaneous fine-needle aspiration biopsies have been performed. Of these, more than 50 liver biopsies have been undertaken with an overall accuracy of approximately 93%.3 In addition, our specificity is 100% with a sensitivity of approximately 92%. We have encountered no complications in our series of liver biopsies.In addition, other interventional radiologists have reported the accuracy of image-guided liver biopsies performed under computed tomographic or ultrasonographic guidance to vary between 88%,4 99%,5 and 90%.6The references quoted by Dr Silberstein are rather outdated, from 1963 and 1972, and these biopsies were performed with so-called


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