From the Hepatology Unit, Division of Gastroenterology, Department of Medicine, Medical School of Ribeirão Preto, São Paulo Univer- sity, and Hepatology Unit, Department of Medicine, University of Campinas, São Paulo, Brazil. Drs. França and Martinelli are Hepatologists, Hepatology Unit, Division of Gastroenterology, Department of Medicine, Medical School of Ribeirão Preto, São Paulo University. Drs. Valério, Sevá-Pereira and Soares are Hepatologists, Hepatology Unit, Department of Medicine, University of Campinas. Dr. Trevisan is Cytologist, Hepatology Unit, Department of Medicine, University of Campinas. Dr. Escanhoela is Pathologist, Hepatology Unit, Department of Medicine, University of Campinas. Dr. Zucoloto is Pathologist, Hepatology Unit, Division of Gastroenterology, Department of Medicine, Medical School of Ribeirão Preto, São Paulo University. Address reprint requests to: Alex Vianey Callado França, M.D., Divisão de Gastroenterologia, Departamento de Clínica Médica, FMRP- USP, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, Brazil (avcfranca@hcrp.fmrp.usp.br). Financial Disclosure: The authors have no connection to any companies or products mentioned in this article. Received for publication May 3, 2002. Accepted for publication September 20, 2002. Fine Needle Aspiration Biopsy for Improving the Diagnostic Accuracy of Cut Needle Biopsy of Focal Liver Lesions Alex Vianey Callado França, M.D., Helena Maria Giordano Valério, M.D., Mirian Trevisan, M.D., Cecília Escanhoela, M.D., Tiago Sevá-Pereira, M.D., Sérgio Zucoloto, M.D., Ana Martinelli, M.D., and Elza Cotrim Soares, M.D. 332 Acta Cytologica 0001-5547/03/4703-0332/$19.00/0 © The International Academy of Cytology Acta Cytologica OBJECTIVE: To determine the value of fine needle aspi- ration biopsy (FNAB) in comparison to cut needle biop- sy (CNB) for the diagnosis of malignancy of focal liver le- sions. STUDY DESIGN: A retro- spective analysis was con- ducted on 68 FNAB and 49 CNB procedures performed on 62 patients with focal liver lesions. RESULTS: Cytology permitted a diagnosis of the lesion in 78% of cases. When punctures with insufficient mate- rial were excluded (11), the diagnostic accuracy of FNAB was 93%. For the 49 patients who underwent both pro- cedures, FNAB and CNB had the same diagnostic accu- racy, 78%, when considered separately and of 88% when considered in combination. Sensitivity, specificity and positive predictive value were similar for the 2 tech- niques. The negative predictive value was 64% for FNAB and CNB used sepa- rately and reached 78% when the 2 techniques were combined. There were no complications during the ex- ecution of FNAB and CNB. CONCLUSION: FNAB is an effective and safe method for the diagnosis of focal he- patic lesions, with diagnostic accuracy similar to that of CNB. When the 2 techniques are combined, the accuracy of the diagnosis of malignancy of focal liver lesions in- creases. (Acta Cytol 2003;47:332–336) Keywords: liver cancer, liver neoplasms, aspiration biopsy, cut needle biopsy, focal liver lesions. The great advantage of combining the 2 techniques was the reduction in false negative results. DO NOT DUPLICATE © Copyrighted Material