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Incidence of delayed complications following percutaneous CT-guided biopsy of bone and soft tissue lesions of the spine and extremities: A 2-year prospective study and analysis of risk factors

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Abstract

Objective

To prospectively evaluate the incidence of delayed complications (bleeding, pain, infection) following CT-guided biopsies of bone or soft tissue lesions and to identify risk factors that predispose to their occurrence.

Materials and methods

All adults presenting for CT-guided biopsy of a bone or soft tissue lesion were eligible for the study. Risk factors considered included patient gender and age, bone versus soft tissue, lesion location, lesion depth, anticoagulation, conscious sedation, coaxial biopsy technique, bleeding during the biopsy, dressing type and duration of placement, final diagnosis, needle gauge, number of passes, and number of days to follow-up. Outcomes measured included fever, pain, bruising/hematoma formation, and swelling and were collected by a follow-up phone call within 14 days of the biopsy. Fisher’s exact test, the Wald Chi-square test, and univariate, multivariate, and stepwise logistic regression were performed to evaluate the influence of the risk factors on the outcomes.

Results

A total of 386 patients participated in the study. The rates of post-biopsy fever, pain, bruising, and swelling were 1.0, 16.1, 15.6, and 9.6 %, respectively. Anticoagulants were identified as a risk factor for fever. Increasing patient age was identified as a risk factor for pain. Female gender and lesion location were identified as risk factors for bruising. Increasing patient age and lesion location were identified as risk factors for swelling.

Conclusions

Patient age, female gender, and lesion location are risk factors for delayed minor complications following CT-guided biopsy of a bone or soft tissue lesion. There were no major complications. None of the complications in this series altered patient management.

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Acknowledgments

The authors would like to thank the numerous physicians who participated in the enrollment and administration of the intake questionnaire for the patients in this study: Essmael Abdel-Dayem, MD, Juan Batlle, MD, Connie Chang, MD, Gregory Czuczman, MD, Brendan Essary, MD, Khashayar Farsad, MD, PhD, Efren Flores, MD, Adam Gustin, MDCM, Jacob Jaremko, MD, Peter MacMahon, MD, Jose Mora, MD, MPH, Michael Preece, MD, Ori Preis, MD, Matthew Schmitz, MD, F Joseph Simeone, MD, James Song, MD, Josue Vasquez, MD, Stewart Worrell, MD, MPH, and Jong Yun, MD. We would also like to thank Michelle Cardillo for helping the authors administer the follow-up telephone questionnaire.

Conflict of interest

The authors declare they have no conflicts of interest.

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Authors and Affiliations

  1. Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA

    Ambrose J. Huang

  2. Institute of Technology Assessment, Massachusetts General Hospital, 101 Merrimac Street, Boston, MA, 02114, USA

    Elkan F. Halpern

  3. Massachusetts General Hospital, 175 Cambridge Street, Boston, MA, 02114, USA

    Daniel I. Rosenthal

Authors
  1. Ambrose J. Huang
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  2. Elkan F. Halpern
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  3. Daniel I. Rosenthal
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Corresponding author

Correspondence to Ambrose J. Huang.

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Huang, A.J., Halpern, E.F. & Rosenthal, D.I. Incidence of delayed complications following percutaneous CT-guided biopsy of bone and soft tissue lesions of the spine and extremities: A 2-year prospective study and analysis of risk factors. Skeletal Radiol 42, 61–68 (2013). https://doi.org/10.1007/s00256-012-1433-2

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  • DOI: https://doi.org/10.1007/s00256-012-1433-2

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