Iodized oil marking guided biopsy of hepatic space-occupying lesions under the protection of hepatic artery catheterization

To investigate the efficacy and safety of iodized oil marking-guided percutaneous biopsy for hepatic space-occupying lesions under hepatic arterial catheter protection. A retrospective analysis was performed on 39 patients who underwent iodized oil marking-guided percutaneous biopsy of hepatic space-occupying lesions with hepatic arterial catheter protection. Pathological diagnostic results and postoperative complications were evaluated. All 39 lesions were successfully marked with iodized oil, and tissue samples were obtained without technical failure. Of these, 35 cases were pathologically positive, yielding a positivity rate of 89.7% and a true-positive rate of 100%. Four cases were pathologically negative, among which one was later confirmed as a false negative, resulting in a false-negative rate of 25% and an overall diagnostic accuracy of 97.4%. Minor postoperative complications occurred in 13 patients, including abdominal pain in 10 cases (25.6%) and subcapsular microbleeding in 3 cases (7.7%), all of which resolved with symptomatic treatment without the need for special intervention. One case (2.6%) of hepatic arterial bleeding was successfully managed with emergency transcatheter arterial embolization, with no serious adverse events reported. Iodized oil marking-guided percutaneous biopsy with hepatic arterial catheterization for hemorrhage control is effective and safe for hepatic space-occupying lesions. It enhances lesion localization, reduces operator dependence, and enables immediate hemostasis, making it suitable for high-risk or difficult-to-localize lesions.