Liver biopsy.

By J. Bruzzi, M. O’connell, J. Murray. New England Journal of Medicine, 2001

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WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 3: liver. (2015, background): “Although liver biopsy has long been the gold standard, it is an invasive procedure with potential complications such as bleeding and severe pain (Bravo et al. 2001; Cadranel et al. 2000).”
Practices of Liver Biopsy in France: Results of a Prospective Nationwide Survey (2000, background): “This study showed that (1) liver biopsy procedures vary greatly in France, (2) hepatitis C is the main indication for liver biopsy at present, (3) US-guidance should be developed to reduce severe complications, and (4) day-care procedures increase acceptance of a future biopsy and should also be use”
Quantitative Assessment of Liver Fat with Magnetic Resonance Imaging and Spectroscopy (2011, background): “It carries a small but not negligible risk of hospitalization (1–3%) and even death (1:10,000) (28).”