Abstract
Background
Few published series are dedicated solely to CT-guided vertebral bone biopsy in children.
Objective
The objective of our study was to review the diagnostic yield of CT-guided vertebral bone biopsy in children.
Materials and methods
A retrospective review of 26 consecutive CT-guided vertebral bone biopsies during a 7-year period in 24 children (16 girls and 8 boys), mean age 8.8 years (range 1–16 years) was performed at our institution. Procedures were reviewed for diagnostic accuracy, biopsy location, complications and final diagnosis.
Results
Twenty-five of 26 biopsies (96%) were technically successful. Twenty-one of 26 biopsies were diagnostic (81%); 2/26 (8%) were false-negative removing non-lesional tissue, 2/26 (8%) were nondiagnostic, and 1/26 (4%) was technically unsuccessful. The diagnoses were as follows: 12/26 biopsies (46%) were osteomyelitis, 3/26 (11%) biopsies were Langerhans cell histiocytosis, 3/26 biopsies (11%) were normal bone, 2/26 (8%) biopsies were malignant tumors, and 1/26 (4%) biopsies was osteoblastoma. There was one self-limited, procedure-related complication: a small right-sided pneumothorax occurred in the setting of attempting to create a protective extrapleural biopsy window.
Conclusion
Percutaneous CT-guided vertebral bone biopsy can be performed safely in children with a high degree of diagnostic accuracy.
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References
Robertson RC, Ball RC (1935) Destructive spine lesions: diagnosis by needle biopsy. J Bone Joint Surg Am 17:749–758
Siffert RS, Arkin AM (1949) Trephine biopsy of bone with special reference to the lumbar vertebral bodies. J Bone Joint Surg Am 31A:146–149
Ottolenghi CE (1969) Aspiration biopsy of the spine. Technique for the thoracic spine and results of twenty-eight biopsies in this region and over-all results of 1050 biopsies of other spinal segments. J Bone Joint Surg Am 51:1531–1544
Adapon BD, Legada BD Jr, Lim EV et al (1981) CT-guided closed biopsy of the spine. J Comput Assist Tomogr 5:73–78
Hryhorczuk AL, Strouse PJ, Biermann JS (2011) Accuracy of CT-guided percutaneous core needle biopsy for assessment of pediatric musculoskeletal lesions. Pediatr Radiol 41:848–857
Shin HJ, Amaral JG, Armstrong D et al (2007) Image-guided percutaneous biopsy of musculoskeletal lesions in children. Pediatr Radiol 37:362–369
Hoffer FA, Strand RD, Gebhardt MC (1988) Percutaneous biopsy of pyogenic infection of the spine in children. J Pediatr Orthop 8:442–444
Garces J, Hidalgo G (2000) Lateral access for CT-guided percutaneous biopsy of the lumbar spine. AJR 174:425–426
Reddy AS, Dinobile D, Orgeta JE et al (2009) Transoral approach to CT-guided C2 interventions. Pain Physician 12:253–258
Hao DJ, Sun HH, He BR et al (2011) Accuracy of CT-guided biopsies in 158 patients with thoracic spinal lesions. Acta Radiol 52:1015–1019
Poyanli O, Akan K, Unay K et al (2008) CT-guided percutaneous transpedicular biopsy for the diagnosis of vertebral lesions. Acta Orthop Belg 74:503–506
Sun HY, Lee JW, Kim KJ et al (2009) Percutaneous intervention of the C2 vertebral body using a CT-guided posterolateral approach. AJR 193:1703–1705
Hau A, Kim I, Kattapuram S et al (2002) Accuracy of CT-guided biopsies in 359 patients with musculoskeletal lesions. Skeletal Radiol 31:349–353
Puri A, Shingade VU, Agarwal MG (2006) CT-guided percutaneous core needle biopsy in deep seated musculoskeletal lesions: a prospective study of 128 cases. Skeletal Radiol 35:138–143
Lis E, Bilsky MH, Pisinski L et al (2004) Percutaneous CT-guided biopsy of osseous lesion of the spine in patients with known or suspected malignancy. AJNR 25:1583–1588
Kornblum MB, Wesolowski DP, Fischgrund JS et al (1998) Computed tomography-guided biopsy of the spine. A review of 103 patients. Spine 23:81–85
Ghelman B, Lospinuso MF, Levine DB et al (1991) Percutaneous computed-tomography-guided biopsy of the thoracic and lumbar spine. Spine 16:736–739
Rimondi E, Staals EL, Errani C et al (2008) Percutaneous CT-guided biopsy of the spine: results of 430 biopsies. Eur Spine J 17:975–981
Virayavanich W, Ringler MD, Chin CT et al (2011) CT-guided biopsy of bone and soft-tissue lesions: role of on-site immediate cytologic evaluation. J Vasc Interv Radiol 22:1024–1030
Yaffe D, Greenberg G, Leitner J et al (2003) CT-guided percutaneous biopsy of thoracic and lumbar spine: a new coaxial technique. AJNR 24:2111–2113
Sucu HK, Bezircioglu H, Cicek C et al (2003) Computerized tomography-guided percutaneous transforaminodiscal biopsy sampling of vertebral body lesions. J Neurosurg 99:51–55
Thanos L, Mylona S, Kalioras V et al (2004) Percutaneous CT-guided interventional procedures in musculoskeletal system (our experience). Eur J Radiol 50:273–277
Enoch DA, Cargill JS, Laing R et al (2008) Value of CT-guided biopsy in the diagnosis of septic discitis. J Clin Pathol 61:750–753
Pierot L, Boulin A (1999) Percutaneous biopsy of the thoracic and lumbar spine: transpedicular approach under fluoroscopic guidance. AJNR 20:23–25
Klaeser B, Wiskirchen J, Wartenberg J et al (2010) PET/CT-guided biopsies of metabolically active bone lesions: applications and clinical impact. Eur J Nucl Med Mol Imaging 37:2027–2036
Fritz J, Thomas C, Tzaribachev N et al (2009) MRI-guided injection procedures of the temporomandibular joints in children and adults: technique, accuracy, and safety. AJR 193:1148–1154
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Ballah, D., Nijs, E., Keller, M.S. et al. Percutaneous CT-guided vertebral bone biopsy in children. Pediatr Radiol 43, 582–588 (2013). https://doi.org/10.1007/s00247-012-2542-8
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DOI: https://doi.org/10.1007/s00247-012-2542-8