Impact of liver biopsy size on histological evaluation of chronic viral hepatitis: the smaller the sample, the milder the disease.

By G. Colloredo, M. Guido, A. Sonzogni, G. Leandro. Journal of Hepatology, 2003

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Computer‐assisted image analysis of liver collagen: Relationship to Ishak scoring and hepatic venous pressure gradient (2009, methodology): “16 Liver histology was scored according to an accepted system by Ishak et al., 29 and hepatic collagen content was assessed using DIA, also an accepted method.”
Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study (2005, background): “liver biopsy in assessing fibrosis may be questioned because of sampling error and interobserver variability that may lead to understaging of cirrhosis (6-9).”
Long‐term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B (2010, methodology): “All biopsy samples with at least three portal areas were evaluated with the understanding that small biopsy samples tend to be underscored for necroinflammation and fibrosis.(37) Baseline biopsy samples had a mean length of 12.”
FIB‐4: An inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest (2007, methodology): “We reviewed our computerized files of HCV-infected patients attending our unit and selected all the cases corresponding to the following criteria: (1) anti HCV- and HCV-RNA–positive; (2) LB prior to any antiviral therapy; (3) laboratory assessments allowing FIB-4 calculation (AST, ALT, platelet coun”