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Percutaneous image-guided needle biopsy of clavicle lesions: a retrospective study of diagnostic yield with description of safe biopsy routes in 55 cases

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Abstract

Objectives

To assess the diagnostic yield and diagnostic accuracy of image-guided percutaneous needle biopsy of clavicle lesions and to analyse the diagnostic spectrum of clavicular lesions referred to a tertiary musculoskeletal oncology centre. To further describe safe biopsy routes for biopsy of the unique clavicle bone.

Materials and methods

A retrospective review of all patients who underwent an image-guided clavicle biopsy during the period from August 2006 to December 2013. A total of 52 patients with 55 consecutive biopsies were identified and included in the study. Image-guided percutaneous biopsy was performed using CT (n = 38) or ultrasound (n = 17).

Results

There were 23 males and 29 females, with a mean age of 40 years (range 2 to 87 years). Forty-six of the 55 biopsies (83.6 %) yielded a diagnostic sample and 9 (16.4 %) were non-diagnostic. Thirty of 46 (65.2 %) lesions were malignant and 16 (34.8 %) were benign/non-neoplastic. The most common malignant lesions were metastases, 22 of 30 (73.3 %), followed by primary tumours in 8 of 30 (26.7 %). The most common benign/non-neoplastic lesion was chronic recurrent multifocal osteomyelitis (4 of 16, 25 %) followed by Langerhans cell histiocytosis, epithelioid haemangioma and osteomyelitis (each with 2 of 16, 12.5 %). There was complete agreement between the needle and surgical histology specimen in 12 of 13 subjects (92.3 %). No post-biopsy complications were reported.

Conclusions

Image-guided percutaneous biopsy has high diagnostic yield and accuracy and the described approaches are a safe means of biopsy for clavicle lesions.

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References

  1. Kulkarni NV. Clinical anatomy: (a problem solving approach). Second edition. JP Medical Ltd 2011. Chapter 3; Cartilage, Bones and Joints: Page 21

  2. Smith J, Yuppa F, Watson RC. Primary tumors and tumor-like lesions of the clavicle. Skeletal Radiol. 1988;17:235–46.

    Article  CAS  PubMed  Google Scholar 

  3. Rossi B, Fabbriciani C, Chalidis BE, Visci F, Maccauro G. Primary malignant clavicular tumours: a clinicopathological analysis of six cases and evaluation of surgical management. Arch Orthop Trauma Surg. 2011;131:935–9.

    Article  PubMed  Google Scholar 

  4. Khoo MMY, Saifuddin A. The role of MRI in image-guided needle biopsy of focal bone and soft tissue neoplasms. Skeletal Radiol. 2013;42:905–15.

    Article  CAS  PubMed  Google Scholar 

  5. Harish S, Hughes RJ, Saifuddin A, Flanagan AM. Image-guided percutaneous biopsy of intramedullary lytic bone lesions: utility of aspirated blood clots. Eur Radiol. 2006;16:2120–5.

    Article  PubMed  Google Scholar 

  6. Liu PT, Valadez SD, Chivers FS, Roberts CC, Beauchamp CP. Anatomically based guidelines for core needle biopsy of bone tumor: implications for limb sparing surgery. Radiographics. 2007;27:189–205.

    Article  PubMed  Google Scholar 

  7. Omura MC, Motamedi K, UyBico S, Nelson SD, Seeger LL. Revisiting CT-guided percutaneous core needle biopsy of musculoskeletal lesions: contributors to biopsy success. AJR. 2011;197:457–61.

    Article  PubMed  Google Scholar 

  8. Pohlig F, Kirchhoff C, Lenze U, Schauwecker J, Burgkart R, Rechl H, et al. Percutaneous core needle biopsy versus open biopsy in diagnostics of bone and soft tissue sarcoma: a retrospective study. Eur J Med Res. 2012;17:29–34.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Rimondi E, Rossi G, Bartalena T, Ciminari R, Alberghini M, Ruggieri P, et al. Percutaneous CT-guided biopsy of the musculoskeletal system: results of 2027 cases. Eur J Rad. 2011;77:34–42.

    Article  Google Scholar 

  10. Basarir K, Polat O, Saglik Y, Yildiz Y. Bone tumors of the clavicle: risk of malignancy in the elderly and safe needle biopsy. Orthopaedics. 2010;33:397.

    Google Scholar 

  11. Anderson HS. Lesions of the clavicle. Radiology. 1931;16:181–6.

    Article  Google Scholar 

  12. Ren K, Wu S, Shi X, Zhao J, Liu X. Primary clavicle tumors and tumorous lesions: a review of 206 cases in East Asia. Arch Orthop Trauma Surg. 2012;132:883–9.

    Article  PubMed  Google Scholar 

  13. Suresh S, Saifuddin A. Unveiling the ‘unique bone’: a study of the distribution of focal clavicular lesions. Skeletal Radiol. 2008;37:749–56.

    Article  CAS  PubMed  Google Scholar 

  14. Clement ND, Nyadu Y, Kelly M, Walmsley P, Porter DE. Malignant lesions are rare in medial third of the clavicle in children: the European juvenile medial end of clavicle tumour study. J Ped Ortho. 2011;20:117–23.

    Article  Google Scholar 

  15. Giedion A, Holthusen W, Masel LF, Vischer D. Subacute and chronic ‘symmetrical’ osteomyelitis. Ann Radiol (Paris). 1972;15:329–42.

    CAS  Google Scholar 

  16. Iyer R, Thapa MM, Chew FS. Chronic recurrent multifocal osteomyelitis: review. AJR. 2011;196:S87–91.

    Article  PubMed  Google Scholar 

  17. Didolkar MM, Anderson ME, Hochman MG, Rissmiller JG, Goldsmith JD, Gebhardt MG, et al. Image guided core needle biopsy of musculoskeletal lesions: are non-diagnostic results clinically useful. Clin Orthop Relat Res. 2013;471:3601–9.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Fletcher CDM, Bridge JA, Hogendoorn P, Mertens F. WHO Classification of Tumours of Soft Tissue and Bone (IARC WHO Classification of Tumours). Fourth edition. World Health Organisation, 2013. Chapter 7: Vascular tumours.

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Pressney, I., Saifuddin, A. Percutaneous image-guided needle biopsy of clavicle lesions: a retrospective study of diagnostic yield with description of safe biopsy routes in 55 cases. Skeletal Radiol 44, 497–503 (2015). https://doi.org/10.1007/s00256-014-2016-1

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  • DOI: https://doi.org/10.1007/s00256-014-2016-1

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