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Factors Affecting Diagnostic Yield of Lesional Bone Biopsy in Hematologic Malignancy Patients

  • CLINICAL INVESTIGATION
  • Musculoskeletal Interventions
  • Published:
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A Correction to this article was published on 08 December 2023

This article has been updated

Abstract

Purpose

To evaluate factors affecting the diagnostic yield (percent of biopsy samples leading to a pathologic diagnosis) of lesional bone biopsies in patients with hematologic malignancies.

Materials and Methods

This retrospective study included 206 lesional bone biopsies in 182 patients with a hematologic malignancy between January 2017 and December 2022. The parameters that were reviewed to evaluate diagnostic yield included biopsy device type (manual vs. electric-powered drill), number of biopsy cores acquired, core biopsy needle gauge, preliminary intra-procedural sample adequacy (touch preparation cytology determining if samples are adequate for final pathologic examination), lesion morphology on Computed Tomography (CT), and presence of crush artifact.

Results

Review of 206 lesional biopsies showed overall diagnostic yield to be 89.8% (185/206). The two statistically significant factors affecting diagnostic yield were biopsy device type and in-room adequacy. 41/42 samples obtained with the electric-powered drill and 144/164 samples obtained using a variety of manual needles were diagnostic (97.6% vs 87.8%, p = 0.03). Of the 192 samples that were assessed for sample adequacy intra-procedurally, 97/102 of the samples that were deemed adequate were diagnostic, and 77/90 of the samples where intra-procedural adequacy was not confirmed were diagnostic (95.1% vs 85.6%, p = 0.018). The remaining factors did not affect diagnostic yield.

Conclusion

The use of an electric-powered drill bone biopsy device and intra-procedural confirmation of sample adequacy are associated with a higher diagnostic yield of lesional bone biopsies in patients with hematologic malignancies. The presence or absence of crush artifact did not significantly affect the diagnostic yield in these patients.

Level of Evidence IV.

Graphical Abstract

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References

  1. Navarro SM, Matcuk GR, Patel DB, Skalski M, White EA, Tomasian A, et al. Musculoskeletal imaging findings of hematologic malignancies. Radiographics. 2017;37(3):881–900. https://doi.org/10.1148/rg.2017160133.

    Article  PubMed  Google Scholar 

  2. Kumar S, Rau AR, Naik R, Kini H, Mathai AM, Pai MRKU. Bone marrow biopsy in non-Hodgkin lymphoma: a morphological study. Indian J Pathol Microbiol. 2009;52:332–8.

    Article  PubMed  Google Scholar 

  3. Riley RS, Hogan TF, Pavot DR, Forysthe R, Massey D, Smith E, et al. A pathologist’s perspective on bone marrow aspiration and biopsy: I. performing a bone marrow examination. J Clin Lab Anal. 2004;18(2):70–90. https://doi.org/10.1002/jcla.20008.

    Article  PubMed  PubMed Central  Google Scholar 

  4. 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 Radiol. 2011;77(1):34–42.

    Article  PubMed  Google Scholar 

  5. Lynch DW, Stauffer SL, Rosenthal NS. Adequacy of powered vs manual bone marrow biopsy specimens: a retrospective review of sequential marrow aspirates and biopsies in 68 Patients. Am J Clin Pathol. 2015;143(4):535–9. https://doi.org/10.1309/AJCP67WITVPVVTNF.

    Article  PubMed  Google Scholar 

  6. Cohen MG, McMahon CJ, Kung JW, Wu JS. Comparison of battery-powered and manual bone biopsy systems for core needle biopsy of sclerotic bone lesions. Am J Roentgenol. 2016;206(5):83–6. https://doi.org/10.2214/AJR.15.15067.

    Article  Google Scholar 

  7. Lee RKL, Ng AWH, Griffith JF. CT-guided bone biopsy with a battery-powered drill system: preliminary results. Am J Roentgenol. 2013;201(5):1093–5. https://doi.org/10.2214/AJR.12.10521.

    Article  Google Scholar 

  8. Swords RT, Kelly KR, Cohen SC, Miller LJ, Philbeck TE, Hacker SO, et al. Rotary powered device for bone marrow aspiration and biopsy yields excellent specimens quickly and efficiently. J Clin Pathol. 2010;63(6):562–5.

    Article  PubMed  Google Scholar 

  9. Kihira S, Koo C, Lee A, Aggarwal A, Pawha P, Doshi A. Reduction of radiation dose and scanning time while preserving diagnostic yield: a comparison of battery-powered and manual bone biopsy systems. Am J Neuroradiol. 2020;41(3):387–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Jain S, Enzerra M, Mehta RS, Smith R, Djokic M. Bone marrow biopsies performed by both the powered OnControl drill device and the Jamshidi needle produce adequate specimens. J Clin Pathol. 2017;70(6):541–3.

    Article  PubMed  Google Scholar 

  11. Glennon CA, Woodroof JM, Kambhampati S, Battershell AC, O’Connor SR, Roberts KB. Comparison of bone marrow biopsy specimens obtained using a motorized device and manual biopsy systems. Asia-Pacific J Oncol Nurs. 2018;5(4):394–8.

    Article  Google Scholar 

  12. Forwood KM, Lee E, Crispin PJ. Comparison of the bone marrow trephine sample quality between OnControl drill system and the Jamshidi needle. Int J Lab Hematol. 2019;41(3):373–9. https://doi.org/10.1111/ijlh.12984.

    Article  PubMed  Google Scholar 

  13. Huh EH, Yi PH, Ray DM, Hsu LCH, Hui FK, Khan M. Comparison of powered drill & manual bone biopsy systems: Does the diagnostic yield justify the cost? J Clin Neurosci. 2020;73:125–9.

    Article  PubMed  Google Scholar 

  14. Mihailescu S-D, Jaselme P, Fontoura M-L, Feddag-Hannachi L, Veresezan E-L, Drieux F, et al. Comparison of bone marrow trephine sample quality between a drill-powered system and a manual needle system. Ann Diagn Pathol. 2022;59:151952.

    Article  PubMed  Google Scholar 

  15. Zensen S, Selvaretnam S, Opitz M, Bos D, Haubold J, Theysohn J, et al. Differences in radiation exposure of CT-guided percutaneous manual and powered drill bone biopsy. Cardiovasc Intervent Radiol. 2021;44(9):1430–8. https://doi.org/10.1007/s00270-021-02851-z.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Wu JS, Goldsmith JD, Horwich PJ, Shetty SK, Hochman MG. Bone and soft-tissue lesions: what factors affect diagnostic yield of image-guided core-needle biopsy. Radiology. 2008;248(3):962–70. https://doi.org/10.1148/radiol.2483071742.

    Article  PubMed  Google Scholar 

  17. Haque M PJ. Immunohistochemistry in lymphomas with crush artifacts. In: The United States and Canadian Academy of Pathology Annual Meeting; 2017.

  18. Hahn PF, Eisenberg PJ, Pitman MB, Gazelle GS, Mueller PR. Cytopathologic touch preparations (imprints) from core needle biopsies accuracy compared with that of fine-needle aspirates. Am J Roentgenol. 1995;165(5):1277–9. https://doi.org/10.2214/ajr.165.5.7572518.

    Article  CAS  Google Scholar 

  19. Tsou M-H, Tsai S-F, Chan K-Y, Horng C-F, Lee M-Y, Chuang A-Y, et al. CT-guided needle biopsy: value of on-site cytopathologic evaluation of core specimen touch preparations. J Vasc Interv Radiol. 2009;20(1):71–6.

    Article  PubMed  Google Scholar 

  20. Kubik MJ, Mohammadi A, Rosa M. Diagnostic benefits and cost-effectiveness of on-site imprint cytology adequacy evaluation of core needle biopsies of bone lesions. Diagn Cytopathol. 2014;42(6):506–13.

    Article  PubMed  Google Scholar 

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Funding

This study was supported by the NIH/NCI Cancer Center Support Grant P30 CA008748.

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Authors and Affiliations

  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, Suite H-118, 1275 York Ave, New York, NY, 10065, USA

    Timothy M. Cooke, Majid Maybody, Elena N. Petre, Ernesto Santos, Eric Lis, Natalie Gangai, Francois H. Cornelis & Amgad M. Moussa

  2. College of Medicine, SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY, 11203, USA

    Timothy M. Cooke

  3. Department of Radiology, University of Nebraska Medical Center, 981045 Nebraska Medical Center, Omaha, NE, 68198, USA

    Ahmed K. Aly

  4. Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Ariela Noy

  5. Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Alexander Y. Chan

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  1. Timothy M. Cooke
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Correspondence to Amgad M. Moussa.

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This study has obtained IRB approval under protocol number 16–402, and the need for informed consent was waived.

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Cooke, T.M., Maybody, M., Aly, A.K. et al. Factors Affecting Diagnostic Yield of Lesional Bone Biopsy in Hematologic Malignancy Patients. Cardiovasc Intervent Radiol 47, 80–86 (2024). https://doi.org/10.1007/s00270-023-03594-9

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  • DOI: https://doi.org/10.1007/s00270-023-03594-9

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