Biopsy of CT-Occult Bone Lesions Using Anatomic Landmarks for CT Guidance

Hillen, Travis J.; Talbert, Robert J.; Friedman, Michael; Long, Jeremiah R.; Jennings, Jack W.; Wessell, Daniel E.; Baker, John R.

doi:10.2214/ajr.16.17468

Cited by 17 publications

(9 citation statements)

References 13 publications

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“…CT fluoroscopy is a useful form of CT guidance because it reduces radiation dose and provides close to real-time visualization of the target and surrounding tissues. 21 CT CNB has also grown in popularity for sampling CT occult lesions that can be localized using adjacent anatomical landmarks for lesions that are more easily identified on PET/CT and/or MRI 22 ( Fig. 5 ).…”

Section: Preprocedural Planning and Biopsy Techniquementioning

confidence: 99%

Concepts in Musculoskeletal Bone and Soft Tissue Biopsy

Mills

Leake

Crawford

et al. 2021

Semin Musculoskelet Radiol

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Imaging-guided needle biopsy of musculoskeletal lesions is a high-yield and low-risk procedure that can be used for definitive characterization of indeterminate bone and soft tissue lesions. Familiarity with the preprocedural, technical, and postprocedural steps is vital for the appropriate management of these cases. Biopsy request triage requires an awareness of definitively benign conditions and other tumor mimics. A complete clinical, laboratory, and imaging work-up is essential for procedural planning and determining pathologic concordance. Consultation with an orthopaedic oncologist is a requisite step to ensure maximizing biopsy yield and to avoid interference with any future limb-sparing surgical intervention. Knowledge of the equipment, pertinent medications, and appropriate biopsy technique can minimize the risk of periprocedural complications. Finally, the radiologist may be required to discuss the concordance of histopathology with preprocedure imaging, perform repeat image-guided biopsy, and carefully interpret sarcoma surveillance imaging examinations.

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Section: Preprocedural Planning and Biopsy Techniquementioning

confidence: 99%

Concepts in Musculoskeletal Bone and Soft Tissue Biopsy

Mills

Leake

Crawford

et al. 2021

Semin Musculoskelet Radiol

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show abstract

“…Bone biopsy is performed using several modalities, including CT, fluoroscopy, ultrasonography (US), and MRI. CT is the most frequently used modality during bone biopsy due to its ability to clearly visualize bone structures and surrounding organs [21][22][23][24]. Generally, CT is the first-choice modality during bone lesion biopsy [13,14].…”

Section: Bone Biopsymentioning

confidence: 99%

Percutaneous Image-guided Needle Biopsy of Musculoskeletal Tumors: Technical Tips

Hasegawa

Chatani

Sato

et al. 2021

Interventional Radiology

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With recent advances in imaging technology, the frequency of detecting musculoskeletal lesions has also increased. Percutaneous image-guided needle biopsy is occasionally required for the diagnosis of such lesions. Moreover, in the era of personalized cancer care, chances in histopathological diagnosis and the importance of histopathological diagnosis by percutaneous needle biopsy are increasing. However, as percutaneous needle biopsy is not a common procedure for musculoskeletal lesions, careful planning and the application of adequate techniques such as hydrodissection and the trans-osseous approach are occasionally required. In this review, we have summarized the indications and techniques for percutaneous image-guided needle biopsy for musculoskeletal lesions, including lymphatic lesions.

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“…MRI findings may be used as a road map during CT-guided biopsy, even for lesions that are occult at CT. Frequent use of MRI and PET/CT in oncology patients has increased the prevalence of CT occult bone lesions (32). In these cases, osseous landmarks at MRI should serve as a guide to identifying the appropriate site in which to perform biopsy at CT. Having access to a previously performed MRI examination during CT-guided biopsy and comparing anatomy side by side can ensure that the appropriate site is sampled (Fig 7) (32).…”

Section: Modality Selectionmentioning

confidence: 99%

Pearls and Pitfalls for Soft-Tissue and Bone Biopsies: A Cross-Institutional Review

et al. 2020

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Management of soft-tissue and bone neoplasms depends on a definitive histologic diagnosis. Percutaneous image-guided biopsy of bone and soft-tissue tumors is a cost-effective and accurate method to obtain a histopathologic diagnosis. Biopsy requests must be approached thoughtfully to avoid numerous potential pitfalls. Hasty biopsy planning places the patient at increased risk for misdiagnosis, delayed therapy, repeated invasive procedures, and substantial morbidity. Biopsy planning begins with a thorough review of the relevant clinical history and pertinent imaging. The biopsy route must be planned in concert with the referring orthopedic oncologist to preserve limb-sparing options. Carefully selecting the most appropriate imaging modality to guide the biopsy increases the chances of reaching a definitive diagnosis. It is also critical to identify and target with expertise the part of the lesion that is most likely to yield an accurate diagnosis. Percutaneous biopsy is a safe procedure, and familiarity with preprocedural laboratory testing parameters, anticoagulation guidelines, and commonly used sedation medications minimizes the risk of complications while ensuring patient comfort. Nondiagnostic biopsy results are not infrequent and may still have value in guiding patient treatment. Awareness of the imaging manifestations of tumor recurrence is also important. The aim of this article is to provide a comprehensive review of pertinent preprocedural, periprocedural, and postprocedural considerations for bone and soft-tissue musculoskeletal biopsies.

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Biopsy of CT-Occult Bone Lesions Using Anatomic Landmarks for CT Guidance

Abstract: Biopsy of CT-occult lesions using anatomic landmarks achieves diagnostic yields similar to those for CT-guided biopsy of CT-evident lesions.

Cited by 17 publications

References 13 publications

Concepts in Musculoskeletal Bone and Soft Tissue Biopsy

Concepts in Musculoskeletal Bone and Soft Tissue Biopsy

Percutaneous Image-guided Needle Biopsy of Musculoskeletal Tumors: Technical Tips

Pearls and Pitfalls for Soft-Tissue and Bone Biopsies: A Cross-Institutional Review

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