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Dr Jewel has provided helpful references on yield of liver biopsies that raise my cited upper limit of positive yields by 6% to 8%. A 99% yield from needle biopsy is indeed spectacular and would be hard to reproduce.It is important to reemphasize that the study of Tempero et al did not dispute the data that I cited. Nor did they discuss the fact that 25% of their cases with normal biochemical test results in patients with proved histological findings of cancer had abnormal liver scans. It would be hard to settle for normal liver function test results alone if one was to miss one of every four cases of hepatic metastases. This is why the liver scan is alive and well!
Silberstein EB. Diagnosis of Metastatic Liver Cancer-Reply. JAMA. 1984;251(2):216–217. doi:10.1001/jama.1984.03340260024014
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