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CT-guided Transosseous Soft Tissue Biopsy: Techniques, Outcomes and Complications in 50 Cases

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Abstract

Purpose

To describe the techniques, outcomes and complications of CT-guided transosseous biopsy of soft tissue lesions via multiple different routes.

Materials and Methods

Clinical and radiologic data from all consecutive soft tissue biopsies performed via a transosseous approach between April 2009 and July 2015 were retrospectively compiled. Fifty biopsies performed in 50 patients (n = 17 males, n = 33 females) were included. Biopsies were performed using a 13-gauge biopsy needle which was advanced through the selected bone to the lesion margin followed by coaxial placement of either an 18- or 20-gauge biopsy gun. Sampling accuracy was determined from the final pathology report as diagnostic or non-diagnostic. Complications included rates of pneumothorax, pneumomediastinum, hemoptysis, immediate admission, chest tube insertion, surgical consultation, 30-day readmission, fracture, osteomyelitis or tract seeding.

Results

Number of diagnostic samples per bone included: sternum (n = 17, 34%), rib (n = 7, 14%), scapula (n = 6, 12%), transverse process (n = 4, 8%), vertebral body (n = 4, 8%), spinous process (n = 1, 2%), ilium (n = 7, 14%), sacrum (n = 4, 8%). Complications included 10 pneumothoraces in 39 cases that crossed the pleura, 8 pneumomediastinum in 17 transsternal cases, one immediate surgical consultation and one 30-day readmission.

Conclusion

Transosseous biopsy approach is a technically feasible means of obtaining core needle samples of soft tissue lesions.

Level of Evidence

Case series, IV.

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Authors and Affiliations

  1. Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, 3601 W 13 Mile Road, Royal Oak, MI, 48073, USA

    Monzer Chehab, Stephen Zintsmaster, Syed Zafar Jafri & Anindya Roy

  2. Cleveland Clinic Regional Radiology, Akron General Hospital, 1 Akron General Ave, Akron, OH, 44307, USA

    Mark Richards

Authors
  1. Monzer Chehab
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  2. Stephen Zintsmaster
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  3. Syed Zafar Jafri
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  4. Mark Richards
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  5. Anindya Roy
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Corresponding author

Correspondence to Stephen Zintsmaster.

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Conflict of interest

All authors have nothing to disclose.

Ethical Approval

For this type of study formal consent is not required. This study was approved by the local institutional review board.

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Chehab, M., Zintsmaster, S., Jafri, S.Z. et al. CT-guided Transosseous Soft Tissue Biopsy: Techniques, Outcomes and Complications in 50 Cases. Cardiovasc Intervent Radiol 40, 1461–1468 (2017). https://doi.org/10.1007/s00270-017-1669-2

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  • DOI: https://doi.org/10.1007/s00270-017-1669-2

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