Ct-guided bone biopsy in cancer patients with suspected bone metastases: retrospective review of 308 procedures
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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.
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.
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.
KeywordsCT-guided bone biopsy Cancer patients Bone metastases
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.
- 7.Sacks D, McClenny TE, Cardella JF, Lewis CA (2003) Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202Google Scholar
- 8.Mantel N (1983) Chi square tests with one degree of freedom: extensions of the Mantel-Haenszel procedure. J Am Stat Assoc 58:690–700Google Scholar
- 9.Jaffe HL (1958) Introduction: problems of classification and diagnosis. Tumors and tumorous conditions of bone and joints. Lea and Febiger, Philadelphia, pp 9–17Google Scholar