Diagnostic Yield and Quality Outcomes of EUS-Guided Liver Biopsies: Findings from Canada’s First and Largest Cohort Study
Bibliographic record
Abstract
Aims EUS-guided liver biopsy (EUS-LB) is a safe and effective technique, consistently yielding diagnostic accuracy with adequate tissue samples. However, most studies are limited by small sample sizes, leaving notable gaps in data. Despite growing international evidence, a comprehensive Canadian experience remains unreported. Our aim is to address this gap by evaluating the diagnostic yield, safety ' procedural efficacy of EUS-guided liver biopsies in a large cohort of patients from a Canadian healthcare setting. Methods This is a retrospective analysis of patients who underwent EUS-LB over a 4 year period. All procedures were performed with a linear echoendoscope using a 1-2 pass, selective-actuation, wet suction technique ' a 19-G Franseen-tip needle using our own institutional protocol. All patients received either conscious or deep sedation. Specimen adequacy was assessed by a GI histopathologist evaluating key parameters including the number of complete portal tracts (CPT), length of longest intact core (LIC), total specimen length (TSL) ' degree of fragmentation, using guideline specific cutoffs where applicable. Comprehensive demographic, clinical ' procedural data were also collected for detailed analyses. Results A total of 142 consecutive patients underwent EUS-LB at Kelowna General Hospital, British Columbia, from April 2020 to October 2024. The median age was 62 years (IQR 52–70), with 109 women (77%) and 33 men (23%). The median BMI was 27 kg/m2 (IQR 24–32). The diagnostic yield was 99.3%, with all but one specimen being diagnostic. Adequate histological specimens were obtained in 136 patients (95.7%), and a conclusive diagnosis was reached in 141 patients (99.3%). The most common diagnosis was metabolic dysfunction-associated steatohepatitis (MASH) in 42 patients (29%), followed by drug-induced liver injury (14.5%), autoimmune hepatitis (13.1%), and primary biliary cholangitis (PBC) (10.3%). At the time of this submission, detailed histopathologic analyses were available for a subset of patients. The median total specimen length (TSL) was 4.4 cm (IQR 3.3–5.2), the median number of complete portal tracts (CPTs) was 13 (IQR 11.5–23.5), and the median longest intact core was 1.3 cm (IQR 1.1–1.7). No major adverse events were observed. Conclusions Our study reinforces the evolving role of EUS-guided liver biopsy in liver diagnostics, demonstrating its safety, efficacy, and high diagnostic yield. This technique not only ensures procedural success but also enhances the autonomy of gastroenterologists, promoting more timely and integrated patient care. As the largest and only study of EUS-guided liver biopsies conducted in a Canadian healthcare setting, it addresses a critical gap in the literature and further validates the role of EUS-LB in modern hepatology practice. Publication History Article published online: 27 March 2025 © 2025. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".