Approach-based techniques of CT-guided percutaneous vertebral biopsy

Singh, Dharmendra Kumar; Kumar, Nishith; Nayak, Bibhu Kalyan; Jaiswal, Binita; Tomar, Sagar; Mittal, Mahesh Kumar; Bajaj, Sharad

doi:10.5152/dir.2019.19268

Cited by 24 publications

(17 citation statements)

References 8 publications

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“…Since the inception of percutaneous biopsy of the spinal lesion, it has become the procedure of choice owing to the less invasive nature of the procedure, thus allowing faster recovery of the patients [3][4][5]. A percutaneous spinal biopsy can be performed in two ways: either with computed tomography (CT)-guided or fluoroscopyguided [6][7][8][9][10]. Both methods have their advantages and disadvantages.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy and Adequacy of Computed Tomography Versus Fluoroscopy-Guided Percutaneous Transpedicular Biopsy of Spinal Lesions

Zakaria@Mohamad¹,

Rahim²,

Kow³

et al. 2022

Cureus

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BackgroundTranspedicular biopsy of spinal lesions is imperative for the generation of a definite diagnosis. Thus far, literature comparing the accuracy and adequacy between fluoroscopy-guided and computed tomography (CT)-guided transpedicular biopsy of spinal lesions is scarce. We aim to compare the accuracy and adequacy of samples collected with the two techniques at the largest tertiary hospital in Malaysia. Materials and methodsA total of 60 patients (37 patients with spinal infection and 23 patients with spinal tumour) underwent percutaneous transpedicular biopsy of spinal lesions from January 2013 to December 2017 at a tertiary centre. Demographic data, biopsy method (fluoroscopy-guided and CT-guided), diagnosis, adequacy, and accuracy of samples obtained were assessed. ResultsAmong the 60 samples obtained, only two samples (3.3%) were deemed inadequate. There were 10 biopsy samples (16.7%) that were inaccurate. There was no statistical difference between fluoroscopy-guided and CT-guided transpedicular biopsy in terms of accuracy (p = 0.731) and adequacy (p = 0.492). ConclusionsFluoroscopy-guided and CT-guided transpedicular biopsy of spinal lesions offer similar accuracy and adequacy. Fluoroscopy-guided biopsy of the spinal lesion will be an option for spine surgeons when CTguided biopsy is not available.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy and Adequacy of Computed Tomography Versus Fluoroscopy-Guided Percutaneous Transpedicular Biopsy of Spinal Lesions

Zakaria@Mohamad¹,

Rahim²,

Kow³

et al. 2022

Cureus

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“…On the other hand, the shorter needle tract, transverse and mammillary processes joining at an acute angle and thereby guiding the needle tip toward the pedicle, and presence of thin cortical bone along the posterior aspect of the pedicle make the transpedicular approach less time consuming than the costotransverse approach. 15 However, there was a statistically significant difference in procedure time between the two techniques. The conventional technique required a longer time (52.5 ± 3.5 minutes) compared with the axis-defined tram-track method (37.3 ± 3.6 minutes) (p < 0.0001).…”

Section: Discussionmentioning

confidence: 89%

Computed Tomography-Guided Vertebral Biopsy in Suspected Tuberculous Spondylodiscitis: Comparing a New Navigational Tram-Track Technique versus Conventional Method

Singh

Sharma

Boruah

et al. 2020

Journal of Clinical Interventional Radiology ISVIR

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Introduction Computed tomography (CT)-guided vertebral biopsy is always recommended for histopathological and microbiological confirmation in cases of tuberculous spondylodiscitis and for antimycobacterial drug sensitivity testing. Aim To compare the conventional technique and a novel axis-defined tram-track technique of CT-guided vertebral biopsy in suspected tuberculous spondylodiscitis. Materials and Methods Sixty-seven patients of clinico-radiologically suspected tuberculous spondylodiscitis referred for CT-guided vertebral biopsy were categorized into two groups: “Group A” patients (n = 32) underwent biopsy by conventional technique, and “Group B” patients (n = 35) by axis-defined tram-track technique. The time taken for procedure, radiation exposure, and any procedural complications were recorded for both the groups. Results A statistically significant difference in procedure time and mean radiation dose was observed between the two groups: a longer procedural time was required in “Group A” (52.5 ± 3.5 minutes) as compared to “Group B” (37.3 ± 3.6 minutes) (p < 0.0001); and mean radiation dose (CTDIvol) in “Group A” and “Group B” was 8.64 ± 1.06 mGy and 5.73 ± 0.71 mGy, respectively (p < 0.0001). However, the difference in complication rate and tissue yield for successful diagnosis of the biopsies in the two groups was found to be statistically insignificant. Conclusion Axis-defined tram-track technique was found to have a significantly shorter procedural time as well as lower radiation exposure compared to the conventional technique of vertebral biopsy in our study.

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“…In our series, no procedures were performed using the anterior/trans-oral approach; nevertheless, in the literature, several successful CT-guided biopsies have been reported using this particular approach [ 12 , 13 , 14 , 15 , 16 ]. Moreover, in some specific locations within the CVJ area (e.g., the dens of the axis), the anterior/trans-oral approach could be the only feasible and safe one to the target lesion.…”

Section: Discussionmentioning

confidence: 97%

Percutaneous CT-Guided Biopsy of the Craniovertebral Junction: Safety, Diagnostic Yield, and Technical Notes

2022

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The craniovertebral junction defined as the occiput, the atlas, and the axis is a complex bony region that contains vital neural and vascular structures. We report the experience of a single academic institution regarding CT-guided biopsy of this skeletal region. We reviewed all of the CT-guided biopsies performed in our department, completed in the craniovertebral junction. We collected data in regard to biopsy procedures, patients’ vital statistics, and histopathological diagnosis. In total, 16 patients (8M and 8F; mean age 52; range 16–86 years old) were included in this series. In eight patients, the lesions were located in the atlas vertebra (8/16—50%), in six patients in the axis (37.5%), and in two patients in the occiput (12.5%). No complications were observed during or after the procedures. All of the procedures were technically successful. The biopsy was diagnostic in 13/16 patients (81.3%): four metastatic lesions (25%—three breast and one prostate cancers), four multiple myeloma bone lesions (25%), three aneurismal bone cysts (18.8%), one aggressive hemangioma (6.3%), and one pseudogout (6.3%). Moreover, in two-thirds (66.6%) of non-diagnostic histological reports, malignancies were excluded. CT-guided percutaneous biopsy is a safe tool and allows obtaining a histological diagnosis, in most cases, even in the most delicate site of the human skeleton—the craniovertebral junction.

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Approach-based techniques of CT-guided percutaneous vertebral biopsy

Cited by 24 publications

References 8 publications

Diagnostic Accuracy and Adequacy of Computed Tomography Versus Fluoroscopy-Guided Percutaneous Transpedicular Biopsy of Spinal Lesions

Diagnostic Accuracy and Adequacy of Computed Tomography Versus Fluoroscopy-Guided Percutaneous Transpedicular Biopsy of Spinal Lesions

Computed Tomography-Guided Vertebral Biopsy in Suspected Tuberculous Spondylodiscitis: Comparing a New Navigational Tram-Track Technique versus Conventional Method

Percutaneous CT-Guided Biopsy of the Craniovertebral Junction: Safety, Diagnostic Yield, and Technical Notes

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