Skip to main content

Advertisement

SpringerLink
Log in

Ct-guided bone biopsy in cancer patients with suspected bone metastases: retrospective review of 308 procedures

  • Diagnostic Imaging in Oncology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The authors assessed the adequacy and sensitivity of CT-guided bone biopsy in 308 procedures performed in 286 cancer patients with suspected bone metastases.

Materials and methods

An electronic search of our CT-guided bone biopsy database was retrospectively performed to evaluate the adequacy of samples and, in the event of negative samples, whether the patients had radiological progression at the site of biopsy (false negative). Adequacy and false-negative rate were compared with radiological features, biopsy location, specimen length and complications to assess any statistically relevant association with a multivariate logistic regression model.

Results

A total of 290/308 (94.1 %) samples were adequate. Forty-five patients had normal bone marrow and were followed-up, with evidence of progression at the site of biopsy in 10 cases (false-negative cases); overall sensitivity was 96.7 %. Specimen length was significantly correlated to the probability of an adequate biopsy (p = 0.035) and inversely correlated to the probability to obtain a false-negative result (p = 0.02). We encountered 11/308 (3.5 %) minor complications and no major complications.

Conclusion

CT-guided biopsy of bone lesions in cancer patients allows for a final diagnosis in 94 % of cases. A specimen longer than 1 cm may lead to a significant result in terms of adequacy and sensitivity. Negative biopsies with positive positron emission tomography or magnetic resonance imaging and specimen shorter than 1 cm should be repeated to avoid a false-negative result.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Rove KO, Crawford ED (2009) Metastatic cancer in solid tumors and clinical outcome: skeletal-related events. Oncology 23(14 Suppl 5):21–27

    PubMed  Google Scholar 

  2. Gogna A, Peh WC, Munk PL (2008) Image-guided musculoskeletal biopsy. Radiol Clin North Am 46:455–473

    Article  PubMed  Google Scholar 

  3. Söderlund V (1996) Radiological diagnosis of skeletal metastases. Eur Radiol 6:587–595

    Article  PubMed  Google Scholar 

  4. Berning W, Freyschmidt J, Ostertag H (1996) Percutaneous bone biopsy, techniques and indications. Eur Radiol 6:875–881

    CAS  PubMed  Google Scholar 

  5. Simmons C, Miller N, Geddie W et al (2009) Does confirmatory tumor biopsy alter the management of breast cancer patients with distant metastases? Ann Oncol 20:1499–1504

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Aurilio G, Monfardini L, Rizzo S et al (2013) Discordant hormone receptor and human epidermal growth factor receptor 2 status in bone metastases compared to primary breast cancer. Acta Oncol 52:1649–1656

    Article  CAS  PubMed  Google Scholar 

  7. Sacks D, McClenny TE, Cardella JF, Lewis CA (2003) Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202

    Google Scholar 

  8. Mantel N (1983) Chi square tests with one degree of freedom: extensions of the Mantel-Haenszel procedure. J Am Stat Assoc 58:690–700

    Google Scholar 

  9. Jaffe HL (1958) Introduction: problems of classification and diagnosis. Tumors and tumorous conditions of bone and joints. Lea and Febiger, Philadelphia, pp 9–17

    Google Scholar 

  10. Kattapuram S, Hornicek FJ, Rosenberg AE et al (2002) Accuracy of CT-guided biopsies in 359 patients with musculoskeletal lesions. Skelet Radiol 31:349–353

    Article  Google Scholar 

  11. Ciray I, Aström G, Sundström C (1997) Assessment of suspected bone metastases. CT with and without clinical information compared to CT-guided bone biopsy. Acta Radiol 38:890–895

    CAS  PubMed  Google Scholar 

  12. Jelinek JS, Murphey MD, Welker JA (2002) Diagnosis of primary bone tumors with image-guided percutaneous biopsy: experience with 110 tumors. Radiology 223:731–737

    Article  PubMed  Google Scholar 

  13. Hwang S, Lefkowitz RA, Landa J et al (2011) Percutaneous CT-guided bone biopsy: diagnosis of malignancy in lesions with initially indeterminate biopsy results and CT features associated with diagnostic or indeterminate results. AJR Am J Roentgenol 197:1417–1425

    Article  PubMed  Google Scholar 

  14. Genant JW, Vandevenne JE, Bergman AG (2002) Interventional musculoskeletal procedures performed by using MR imaging guidance with a vertically open MR unit: assessment of techniques and applicability. Radiology 223:127–136

    Article  PubMed  Google Scholar 

  15. Roberts CC, Morrison WB, Leslie KO et al (2005) Assessment of bone biopsy needles for sample size, specimen quality and ease of use. Skelet Radiol 34:329–335

    Article  CAS  Google Scholar 

  16. James AW, Robert MH, James J et al (2000) The percutaneous needle biopsy is safe and recommended in the diagnosis of musculoskeletal masses. Cancer 89:2677–2686

    Article  Google Scholar 

Download references

Conflict of interest

Lorenzo Monfardini, Lorenzo Preda, Gaetano Aurilio, Stefania Rizzo, Vincenzo Bagnardi, Giuseppe Renne, Sara Maccagnoni, Paolo Della Vigna, Disalvatore Davide, Massimo Bellomi declare no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology Milan, European Institute of Oncology, Via Ripamonti 435, 20100, Milan, Italy

    Lorenzo Monfardini, Lorenzo Preda, Stefania Rizzo, Paolo Della Vigna & Massimo Bellomi

  2. Unit of Medical Care Milan, European Institute of Oncology, Milan, Italy

    Gaetano Aurilio

  3. Division of Epidemiology and Biostatistics Milan, European Institute of Oncology, Milan, Italy

    Vincenzo Bagnardi & Disalvatore Davide

  4. Laboratory Medicine Milan, Division of Pathology, European Institute of Oncology, Milan, Italy

    Giuseppe Renne

  5. School of Medicine Milan, University of Milan, Milan, Italy

    Sara Maccagnoni & Massimo Bellomi

Authors
  1. Lorenzo Monfardini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lorenzo Preda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gaetano Aurilio
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stefania Rizzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Vincenzo Bagnardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giuseppe Renne
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sara Maccagnoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Paolo Della Vigna
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Disalvatore Davide
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Massimo Bellomi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lorenzo Monfardini.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Monfardini, L., Preda, L., Aurilio, G. et al. Ct-guided bone biopsy in cancer patients with suspected bone metastases: retrospective review of 308 procedures. Radiol med 119, 852–860 (2014). https://doi.org/10.1007/s11547-014-0401-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-014-0401-4

Keywords

Search

Navigation