Bone and Soft-Tissue Lesions: What Factors Affect Diagnostic Yield of Image-guided Core-Needle Biopsy?

Wu, Jim S.; Goldsmith, Jeffrey D.; Horwich, Perry J; Shetty, Sanjay K.; Hochman, Mary G.

doi:10.1148/radiol.2483071742

Cited by 201 publications

(206 citation statements)

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“…The scar from a percutaneous core needle biopsy is a puncture of the surface, but in deep tissues it has a tridimensional shape that is difficult to predict reliably. The accuracy of core needle biopsies ranges from 77% to 97% in published series [16,17,22,[28][29][30][31][32][33][34]. It is excellent for bone sarcomas (77%-96%) and possibly less so for soft tissue sarcomas (76%-78%).…”

Section: Introductionmentioning

confidence: 99%

Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas?

Barrientos-Ruiz

Ortiz‐Cruz

Serrano-Montilla

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background A biopsy is the final step in the diagnosis of sarcomas. Complete resection of the biopsy tract traditionally has been recommended in musculoskeletal oncology guidelines, as that tract is considered potentially seeded with tumor cells. However, to our knowledge, the frequency and implications of contamination of the biopsy tract-specifically with respect to the likelihood of local recurrence-and the factors that affect cell seeding are not well described. Questions/purposes We asked: (1) How often are biopsy tracts contaminated with pathologically detectable tumor cells at the time of tumor resection? (2) What factors, in particular biopsy type (open versus percutaneous), are associated with tumoral seeding? (3) Is biopsy tract contamination associated with local recurrence? Methods This is a retrospective study of a database with patient data collected from a single center between 2000 and 2013. We treated 221 patients with sarcomas. A total of 27 patients (12%) were excluded and 14 (6%) were lost to followup. One hundred eighty patients finally were included in the analysis who either had biopsies at our center (112) or biopsies at outside institutions (68). Of those performed at our center, 15 (13%) were open and 97 (87%) were percutaneous; of those at outside centers, those numbers were 47 (69%) and 21 (31%) respectively. Median followup was 40 months (range, 24-152 months). During the study period, we generally performed percutaneous biopsies as a standard practice for the diagnosis of bone and soft tissue sarcomas and open biopsies were done when the percutaneous procedure failed to provide a histologic characterization. The mean age of the population was 48 years (range, 7-87 years); 60% were male; 42% had bone sarcomas. Nineteen patients had preoperative radiotherapy and 56 had postoperative radiotherapy. Fifty-seven patients received neoadjuvant chemotherapy and 73 had Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution has or waived for the human protocol for this investigation and that all investigations were conducted in conformity with ethical and confidentiality principles of research. This work was performed at the Musculoskeletal Tumor Unit, Orthopaedics and Traumatology Department, at La Paz University Hospital, Madrid, Spain. We determined what proportion of biopsy tracts were contaminated by pathologic analysis of the biopsy tract specimen; during the period in question, our routine practice was to excise the biopsy tract whenever possible at the time of the definitive resection. Using the logistic regression test and Mantel-Haenszel test, we compared open wi...

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Section: Introductionmentioning

confidence: 99%

Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas?

Barrientos-Ruiz

Ortiz‐Cruz

Serrano-Montilla

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…The reported diagnostic yield of percutaneous biopsy of musculoskeletal lesions in the literature is 69%-90% [7][8][9][10][11][12][13][14]. Our success rate (in terms of diagnostic material yield) of 89% corresponds to the high end of the reported data.…”

Section: Discussionmentioning

confidence: 53%

Image-Guided Percutaneous Bone Biopsy with a Simulated Van Sonnenberg Removable Hub System

Özdemi̇r

Kahraman

Baysal

et al. 2015

EAJM

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Objective: To retrospectively examine the success and complication rates associated with image-guided percutaneous bone biopsy with a simulated Van Sonnenberg removable hub system. Materials and Methods:During a 3.5-year period, 27 bone lesions at different anatomic locations with an indication for biopsy based on plain film, computed tomography (CT) and/or magnetic resonance imaging (MRI) findings were determined, and a total of 28 imageguided (fluoroscopy or CT) percutaneous biopsies were performed using a simulated Van Sonnenberg -removable hub system. This technique entailed the use of a cut-out Chiba needle hub that performed as a guide for the insertion of a larger needle. Either core and aspiration biopsy or core biopsy alone was utilized. Results:The procedure yielded diagnostic material 89% of the cases (48% infection, 22% benign lesions, and 19% malignant lesions). Combined use of core and aspiration biopsy resulted in a higher diagnostic accuracy as compared to core biopsy alone. No false positive or false negative diagnoses were observed. No serious complications such as neurological deficits, bleeding, or organ injury were observed. Conclusion:The simulated Van Sonnenberg removable hub system provides a useful technique for percutaneous bone biopsies and is particulary suitable for deep seated (such as vertebral) lesions with its ability to facilitate the accessibility of the lesion with its built-in guidance needle. The procedure is safe in light of the literature data. Keywords: Bone, image-guided biopsy, Van Sonnenberg ÖzetAmaç: "Van Sonnenberg removable hub" sisteminin simüle edilmesi ile yapılan görüntüleme eşliğinde kemik biyopsilerinin başarı ve komplikasyon oranlarını retrospektif olarak değerlendirmek Gereç ve Yöntem: 3,5 yıl süresince farklı anatomik lokasyonlarda yer alan 27 kemik lezyonu direk grafi, bilgisayarlı tomografi (BT) ve/veya manyetik rezonans görüntüleme (MRG) bulguları ile değerlendirildi ve "Van Sonnenberg removable hub sistemi" simülasyonu ile toplam 28 görüntüleme eşliğinde (floroskopi veya BT) biyopsi işlemi yapıldı. Bu yöntemde Chiba iğnesi, başlığı (hub) kesilerek üzerinden daha büyük iğnelerin geçişini sağlayan bir klavuz olarak kullanıldı. Biyopsi materyalleri kor ve aspirasyon biyopsisinin birlikte veya yalnızca kor biyopsinin kullanımı ile elde edildi. Bulgular:Vakaların %89'unda (%48 enfeksiyon, %22 benign lezyonlar, %19 malign lezyonlar) tanı koydurucu materyal elde edildi. Kor ve aspirasyon biyopsisinin birlikte kullanımı yalnızca kor biyopsinin kullanımı ile karşılaştırıldığında daha yüksek tanısal doğruluk oranlarına sahipti. Yalancı pozitif veya negatif tanı ile karşılaşılmadı. Nörolojik hasar, kanama veya organ hasarı gibi ciddi komplikasyon meydana gelmedi.Sonuç: "Van Sonnenberg removable hub" sistemi simülasyonu, sağ-ladığı klavuz iğne yöntemi sayesinde özellikle vertebra gibi derin yerleşimli kemik lezyonlarına ulaşımı kolaylaştıran uygun ve kullanışlı bir yöntem olup literatür bilgileri ışığında perkütan kemik biyopsilerinde bu tekniğin kullanımı ...

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“…Specifically, there is a knowledge gap regarding the quality measures which ensure not only a safe biopsy but one with high diagnostic yield (the likelihood the test will provide a diagnosis). To date, only one paper has made recommendations for biopsy of softtissue and bone sarcomas; however, of note, these recommendations did not focus specifically on retroperitoneal lesions [24]. In this study, the diagnostic yield (total number of biopsies that yield a diagnosis divided by total number of biopsies) was 77% for all lesions and there were no differences in yield according to needle gauge or imaging modality.…”

Section: Needle Tract Seedingmentioning

confidence: 63%

Ensuring a Safe and Qualitative Diagnostic Biopsy for Retroperitoneal Sarcomas

Ambacher

Ibrahim

Nessim

2017

UOJM

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Les sarcomes rétropéritonéaux constituent un tiers des néoplasmes du rétropéritoine, et représentent ainsi une entité importante lors de l'évaluation de masses dans cet espace. Ils sont souvent découverts fortuitement puisqu'ils se manifestent par des symptômes non spécifiques et sont seulement décelables à l'examen physique lorsqu'ils atteignent une taille considérable. Ce groupe de tumeurs représente un défi pour les médecins, car il comprend plus de 50 différents sous-types histologiques et le traitement dépend largement du diagnostic histopathologique. La biopsie de ces lésions est récemment devenue la norme en matière de soins pour l'évaluation d'un sarcome rétropéritonéal soupçonné. Toutefois, par le passé, certains ont suggéré que cette pratique puisse possiblement disséminer le cancer et causer une récidive locale, ce qui a limité la recherche sur le sujet. Ainsi, il existe un manque de littérature décrivant les paramètres optimaux pour effectuer une biopsie sécuritaire et efficace de ces lésions. Notre recherche en cours vise à identifier les paramètres de biopsie qui produisent une biopsie diagnostique sécuritaire et qualitative, tout en minimisant les complications et les risques de récidive locale, dans le but de fournir des soins uniformes et de haute qualité à tous les patients avec des lésions rétropéri-tonéales.

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Bone and Soft-Tissue Lesions: What Factors Affect Diagnostic Yield of Image-guided Core-Needle Biopsy?

Abstract: Diagnostic yield is higher in lytic than in sclerotic bone lesions, in larger lesions, and for longer specimens. Obtaining a minimum of three specimens in bone lesions and four specimens in soft-tissue lesions optimizes diagnostic yield.

Cited by 201 publications

References 28 publications

Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas?

Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas?

Image-Guided Percutaneous Bone Biopsy with a Simulated Van Sonnenberg Removable Hub System

Ensuring a Safe and Qualitative Diagnostic Biopsy for Retroperitoneal Sarcomas

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