Percutaneous Image-Guided Biopsy of the Spleen: Experience at a Single Tertiary Care Center

Abstract

Purpose: The purpose of this study is to assess the complication rate of percutaneous image-guided biopsy of the spleen at our institution and to evaluate for variables associated with complication rate. Methods: This is a Research Ethics Board approved retrospective study of consecutive patients who underwent image-guided biopsy of the spleen at our institution from January 2010 to November 2019. Complications, imaging findings, and pathologic diagnosis were reviewed. Complications (major and minor) were classified per Society of Interventional Radiology Guidelines, and complication rate was calculated. Logistic regression was applied to determine factors associated with complications. Diagnostic yield was calculated. Results: In all, 55 patients (28 female) underwent splenic biopsy using ultrasound guidance. The most common indication was possible lymphoma in 41 (71.7%) patients followed by query metastasis 18 (31.5%) patients. Core biopsies (18 g/20 g) were done in 53 (92%) cases, and fine-needle aspiration (22 g) was performed in 4 (8%). The median number of samples collected was 4 (range: 2-9). The results were diagnostic in 54 cases (94.7%, 95% confidence interval [CI]: 88.7-100.0). There were 12 (21%, 95% CI: 10.1-31.9) patients with minor complications and 2 (3.5%, 95% CI: 0.0-8.4) with major complications (2 splenic bleeds requiring embolization, no splenectomy, or deaths). No variables (needle size, lesion size, and number of passes) were associated with complication rate. Conclusion: Percutaneous image-guided biopsy of the spleen at a single tertiary care institution demonstrates major complication rate comparable to that in the literature with no variables associated with complication rate; there were no cases of splenectomy or death.