Abstract
Introduction
We determined the diagnostic accuracy rate of 207 cases that underwent CT-guided needle biopsy for musculoskeletal lesions during the past 10 years, and describe the efficacy and indications of this method.
Materials and methods
We retrospectively analyzed a consecutive series of 207 cases that presented to our oncology group and underwent CT-guided needle biopsy during the 10-year period between April 1998 and March 2008. Diagnostic accuracy was assessed statistically by anatomical location and final diagnosis. The biopsy site was the spine/sacrum in 70 cases, pelvis in 53, extremities in 51, rib/scapula in 20, and retroperitoneum in 13. Bone lesions were detected in 176 cases and soft tissue lesions in 31. The final diagnosis was metastatic tumor in 63 cases, primary bone tumor in 63, primary soft tissue tumor in 23, infection in 18, and hematopoietic malignancy in 16 and non-tumorous lesions in 24.
Results
The diagnostic accuracy rate for all cases was 90%. No serious complications were seen. No statistically significant difference was found by anatomical site. According to the final diagnosis, benign tumors/malignant tumors (p < 0.005), primary bone tumor (p < 0.01), and infectious conditions (p < 0.001) showed significantly low diagnostic accuracy rates.
Discussion
CT-guided needle biopsy is a safe method with high diagnostic accuracy for musculoskeletal lesions. However, in patients with a primary bone tumor, it should be indicated for the initial diagnosis. If a comprehensive assessment based on the imaging conflicts with the pathological findings, an open biopsy should be considered.
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References
Carrasco CH, Wallace S, Richli WR (1991) Percutaneous skeletal biopsy. Cardiovasc Intervent Radiol 14:69–72
Den Heeten GJ, Oldhoff J, Oosterhuis JW, Schraffordt Koops H (1985) Biopsy of bone tumours. J Surg Oncol 28:247–251
Dupuy DE, Rosenberg AE, Punyaratabandhu T, Tan MH, Mankin HJ (1998) Accuracy of CT-guided needle biopsy of musculoskeletal neoplasms. AJR Am J Roentgenol 171:759–762
Hau A, Kim I, Kattapuram S, Hornicek FJ, Rosenberg AE, Gebhardt MC, Mankin HJ (2002) Accuracy of CT-guided biopsies in 359 patients with musculoskeletal lesions. Skeletal Radiol 31:349–353
Kattapuram SV, Rosenthal DI (1987) Percutaneous biopsy of the cervical spine using CT guidance. AJR Am J Roentgenol 149:539–541
Kornblum MB, Wesolowski DP, Fischgrund JS, Herkowitz HN (1998) Computed tomography guided-biopsy of the spine: a review of 103 patients. Spine 23:81–85
Krause ND, Haddad ZK, Winalski CS, Ready JE, Nawfel RD, Carrino JA (2008) Musculoskeletal biopsies using computed tomography fluoroscopy. J Comput Assist Tomogr 32:458–462
Logan PM, Connell DG, O’Connell JX, Munk PL, Janzen DL (1996) Image-guided percutaneous biopsy of musculoskeletal tumors: an algorithm for selection of specific biopsy techniques. AJR Am J Roentgenol 166:137–141
Puri A, Shingade VU, Agarwal MG, Anchan C, Juvekar S, Desai S, Jambhekar NA (2006) CT-guided percutaneous core needle biopsy in deep seated musculoskeletal lesions: a prospective study of 128 cases. Skeletal Radiol 35:138–143
Rimondi E, Staals EL, Errani C, Bianchi G, Casadei R, Alberghini M, Malaguti MC, Rossi G, Durante S, Mercuri M (2008) Percutaneous CT-guided biopsy of the spine: results of 430 biopsies. Eur Spine J 17:975–981
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Tsukushi, S., Nishida, Y., Yamada, Y. et al. CT-guided needle biopsy for musculoskeletal lesions. Arch Orthop Trauma Surg 130, 699–703 (2010). https://doi.org/10.1007/s00402-009-1030-6
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DOI: https://doi.org/10.1007/s00402-009-1030-6