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CT-guided bone marrow aspirations and biopsies: retrospective study and comparison with blind procedures

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Abstract

Purpose

To compare the pathology results of CT-guided and blind bone marrow aspirations and biopsies.

Methods

Ninety-eight consecutive CT-guided biopsies and 98 age- and gender-matched blind (non-CT-guided) posterior iliac crest bone marrow aspirations and biopsies performed in 2017 were reviewed for adequacy of core biopsies and aspirate smears. CT procedure images and CT abdomen/pelvis images were reviewed to evaluate anatomic features of the posterior ilium and soft tissues. Statistical analysis was performed using a T test, Fisher exact test, and Kruskal-Wallis test.

Results

There was no significant difference in the age and gender of the two groups (p > 0.05). However, the CT-guided group had a higher BMI (p = 0.0049) and posterior soft tissue thickness (p = 0.0016). More CT-guided biopsy samples (CT 93 (95%); blind 77 (79%); p = 0.0006) and aspirate smears (CT 90 (92%); blind 78 (80%); p = 0.042) were categorized as adequate. The CT-guided group had longer core lengths (CT 1.4 ± 0.6 (range 0.3–3.5) cm; blind 1.0 ± 0.60 (range 0–2.6) cm; p = 0.0001). Overall, 131/164 (80%) of the cases had at least one of the described features (slanted posterior ilium (angle > 30°), 30%; rounded posterior ilium, 20%; thick posterior ilium cortex, 13%; focal lesion in posterior ilium, 12%; prior procedure in posterior ilium, 5%; posterior soft tissue thickness > 3 cm, 40%).

Conclusion

CT-guided bone marrow procedures were more likely to result in both adequate aspirate smears and biopsy samples and longer core lengths when compared with blind procedures.

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Authors and Affiliations

  1. Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA

    C. Y. Chang, J. S. Husseini, F. J. Simeone & M. A. Bredella

  2. Harvard Medical School, Cambridge, MA, USA

    C. Y. Chang, J. S. Husseini, A. J. Yee, M. A. Bredella & R. Hasserjian

  3. Department of Radiology, Centro Hospitalar São João, Porto, Portugal

    A. Moreira

  4. Division of Hematology and Oncology, Massachusetts General Hospital, Boston, MA, USA

    A. J. Yee

  5. Department of Pathology, Massachusetts General Hospital, Boston, MA, USA

    R. Hasserjian

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  1. C. Y. Chang
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Correspondence to C. Y. Chang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was waived for individual participants included in the study. The study was approved by the local Institutional Review Board (IRB) and HIPAA compliant.

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Chang, C.Y., Husseini, J.S., Moreira, A. et al. CT-guided bone marrow aspirations and biopsies: retrospective study and comparison with blind procedures. Skeletal Radiol 49, 1285–1294 (2020). https://doi.org/10.1007/s00256-020-03423-x

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  • DOI: https://doi.org/10.1007/s00256-020-03423-x

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