Wang C-W et al. (2005) Safety of fine-needle aspiration in patients with small hepatocellular carcinoma. Hepatol Res 31: 31–35

A recent study by Wang et al. has investigated the use of fine-needle aspiration in the diagnosis of small hepatocellular carcinoma (HCC). Although the procedure is considered to be accurate and cost-effective, the risks of dissemination of cancer cells and arterioportal shunt have not been quantified.

Wang et al. carried out a retrospective review of 90 patients with small HCC. All patients had undergone ultrasound-guided fine-needle aspiration for their definitive diagnosis, and were assessed by angiography no more than 50 days later.

Arterioportal shunt occurred in one patient (1.1%). Because angiography was not performed before aspiration, it was not possible to determine whether this was caused by the aspiration procedure itself or by tumor invasion. The authors acknowledge that the incidence of iatrogenic arterioportal shunt might have been underestimated, as small shunts may have sealed during the interval between aspiration and angiography. No new nodules were located in the needle tract, however, indicating that the development of new nodules was not related to the aspiration procedure.

Wang et al. conclude that ultrasound-guided, fine-needle aspiration can be safely used in the diagnosis of small HCC.