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Review of CT-guided trans-osseous biopsies

  • Special Section: Cross Sectional Interventions
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Percutaneous image-guided biopsy is an invaluable technique in the management of a myriad of different conditions; however, percutaneous access to some targets remains challenging. Trans-osseous biopsy provides safe, high-yield access to many challenging lesions in the chest, abdomen, and pelvis which might otherwise require more invasive procedures, such as mediastinoscopy or surgery to establish a histological diagnosis. Additionally, trans-osseous biopsy is well tolerated and may reduce the risk of injury to intervening vital structures as compared to other percutaneous techniques. In this article we review the indications, technical challenges, alternative techniques, and potential complications of trans-sternal, trans-costal, trans-scapular, trans-vertebral, trans-iliac, and trans-sacral biopsies.

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References

  1. Gupta S, Wallace MJ, Morello FA, Ahrar K, Hicks ME. CT-guided Percutaneous Needle Biopsy of Intrathoracic Lesions by Using the Transsternal Approach: Experience in 37 Patients. 2002, Radiology. 2002 Jan;222(1):57–62.

  2. CT-guided Transosseous Soft Tissue Biopsy: Techniques, Outcomes and Complications in 50 Cases. Chehab M, Zintsmaster S, Jafri SZ, Richards M, Roy A. Cardiovasc intervent radiol. 2017 Sep;40(9):1461–1468.

  3. Audran M, Maury E, Bouvard B, Legrand E, Baslé MF, Chappard D. Is Transiliac Bone Biopsy a Painful Procedure? Clin Nephrol. 2012 Feb;77(2):97-104.

    Article  Google Scholar 

  4. D'Agostino H, Sanchez R, Laoide R, Oglevie S, Donaldson J, Russack V, Villaveiran R, vanSonnenberg E. Anterior Mediastinal Lesions: Transsternal Biopsy with CT Guidance. Work in Progress. Radiology. 1993 Dec;189(3):703-705.

    CAS  PubMed  Google Scholar 

  5. Patel IJ, Rahim S, Davidson JC, Hanks SE, Tam AL, Walker G, Wilkins LR, Sarode R, Weinberg I. Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part II: Recommendations. J Vasc Interv Radiol. 2019 Aug;30(8):1168-1184.

    Article  Google Scholar 

  6. Rossi UG, Seitun S, Ferro C. MDCT-Guided Transthoracic Needle Aspiration Biopsy of the Lung Using the Transscapular Approach. Cardiovasc Intervent Radiol. 2011 Feb;34(1):184-187.

    Article  Google Scholar 

  7. Various Approaches for CT-guided Percutaneous Biopsy of Deep Pelvic Lesions: Anatomic and Technical Considerations. Gupta S, Nguyen HL, Morello Jr. FA, Ahrar K, Wallace MJ, Madoff DC, Murthy R, Hicks ME. RadioGraphics. Jan-Feb 2004;24(1):175–189.

  8. Aström G, Ahlström H, Hagberg H. CT-Guided Transvertebral Core Biopsy of a Retrocrural Mass. Am Journal Roentgenol. 1997 Oct;169(4): 991-993.

    Article  Google Scholar 

  9. Aström G, Ahlström H, Magnusson A. CT-guided Transsternal Core Biopsy of Anterior Mediastinal Masses. Radiology. 1996 May;199(2): 564-566.

    Article  Google Scholar 

  10. Langen HJ, Klose KC, Keulers P, Adam G, Jochims M, Günther R. Artificial Widening of the Mediastinum to Gain Access for Extrapleural Biopsy: Clinical Results. Radiology. 1995 Sep;196(3): 703-706.

    Article  CAS  Google Scholar 

  11. Glassberg R, Sussman S. Life-Threatening Hemorrhage Due to Percutaneous Transthoracic Intervention: Importance of the Internal Mammary Artery. Am J Roentgenol. 1990 Jan;154(1):47-49.

    Article  CAS  Google Scholar 

  12. Boskovic T, Stanic J, Pena-Karan S, Zarogoulidis P, Drevelegas K, Katsikogiannis N, Machairiotis N, Mpakas A, Tsakiridis K, Kesisis G, Tsiouda T, Kougioumtzi I, Arikas S, Zarogoulidis K. Pneumothorax after Transthoracic Needle Biopsy of Lung Lesions Under CT Guidance. J Thorac Dis. 2014. Mar;6 Suppl 1(Suppl 1):S99-S107.

  13. Truneh T, Coventry L, Billingsley S, O'Neill C, McDonald F, Warakaulle DR, Warakaulle JN, Yanny S, Hughes RJ, McKean D. Transosseous Soft Tissue Biopsy: Tips and Tricks. ESSR 2019, s.l., Lisbon, Portugal.

  14. Birchard KR. Transthoracic needle biopsy. Seminars in Interventional Radiology 2011:87–97.

  15. Hagberg H, Ahlström H, Magnusson A, Aström G. Value of Transsternal Core Biopsy in Patients with a Newly Diagnosed Mediastinal Mass. Acta Oncol. 2000;39(2):195-198.

    Article  CAS  Google Scholar 

  16. Rapport RL, Ferguson GS. Dorsal Approach to Presacral Biopsy: Technical Case Report. 1997, Neurosrugery, pp. 1087–1088.

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Authors and Affiliations

  1. Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy St., Providence, RI, 02903, USA

    Andrew Mark, Adib R. Karam & David J. Grand

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  1. Andrew Mark
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  2. Adib R. Karam
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  3. David J. Grand
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Contributions

AM: Literature review; first draft of the manuscript. ARK: Cases gathering; literature review; drafting and revision of the manuscript. DJG: Cases gathering; revision of the manuscript.

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Correspondence to Adib R. Karam.

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The authors, Andrew Mark, MD, Adib R. Karam, MD, and David J. Grand, MD declare no conflicts of interest.

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Mark, A., Karam, A.R. & Grand, D.J. Review of CT-guided trans-osseous biopsies. Abdom Radiol 47, 2612–2622 (2022). https://doi.org/10.1007/s00261-021-03167-9

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  • DOI: https://doi.org/10.1007/s00261-021-03167-9

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