Clinical Utility of Percutaneous Biopsies of Musculoskeletal Tumors

“…A previous study analyzed the combination of NCB and FNAC and found 63% were useful to guide treatment and 26.5% required open biopsy [22]. The clinical usefulness of FNAC for evaluation and management of soft tissue masses is based on whether the technique reliably supplies adequate information for initial triage and selection of appropriate therapy.…”

Section: Discussionmentioning

confidence: 99%

Fine Needle Aspiration for Clinical Triage of Extremity Soft Tissue Masses

Thomas

Crist

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Fine needle aspiration cytology (FNAC) is a rapid and low-morbid alternative to open biopsy or needle core biopsy for soft tissue masses. Numerous reports describe its use with metastatic or recurrent lesions, but FNAC is less accepted for primary lesions. Questions/Purposes We wished (1) to estimate the sensitivity, specificity, and positive and negative predictive values of FNAC for diagnosing malignancy; (2)

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“…It is clear, however, that nondiagnostic (ND) needle biopsies are a challenge to clinicians, pathologists, and patients as they potentially delay diagnosis and treatment and increase patient anxiety [20]. Published series have documented that overall ND rates for image-guided needle biopsies range between 5% and 29% [1,8,15,17]. Specific diagnoses rarely are reported to have an effect on the ND rates [14,15], although sclerotic or necrotic lesions are more difficult to diagnose [3,7,8,14].…”

Section: Introductionmentioning

confidence: 99%

“…The image-guided needle biopsy is an established method used to diagnose musculoskeletal tumors [9,17]. There has been a shift away from open incisional biopsies at major cancer centers as interventional radiologists and musculoskeletal pathologists gain skills in procuring and processing core biopsies and fine-needle aspirates [2,4,5,21].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Nondiagnostic Results after Image-guided Needle Biopsies of Musculoskeletal Lesions

Yang

Frassica

Fayad³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background/rationale Image-guided needle biopsies are commonly used to diagnose musculoskeletal tumors, but nondiagnostic (ND) results can delay diagnosis and treatment. It is important to understand which factors or diagnoses predispose to a ND result so that appropriate patient education or a possible change in the clinical plan can be made. Currently it is unclear which factors or specific lesions are more likely to lead to a ND result after image-guided needle biopsy. Questions/purposes We therefore identified specific factors and diagnoses most likely to yield ND results. We also asked whether an image-guided needle biopsy of bone and soft tissue lesions is an accurate and clinically useful tool. Methods We retrospectively reviewed data from a prospectively collected database for a case-control study of 508 image-guided needle biopsies of patients with suspected musculoskeletal tumors between 2003 and 2008. Results The interpretations of 453 of the 508 (89%) needle biopsies were accurate and clinically useful. Fortyfive biopsies (9%) were ND and 10 (2%) were incorrect (IC). Bone lesions had a higher ND rate than soft tissue lesions (13% vs. 4%). The specific diagnosis with the highest ND rate was histiocytosis. Elbow and forearm locations had higher ND rates than average. Malignant tumors had a higher IC rate than benign tumors (5% vs. 0%); fibromyxoid sarcoma and rare subtypes of osteosarcoma had higher IC rates than other diagnoses. Repeat needle or open biopsies were performed in 71 (14%) patients. Bone lesions were more likely than soft tissue lesions to require repeat biopsies (18% vs. 9%). Conclusions A high rate of accuracy and clinical usefulness is possible with image-guided needle biopsies of musculoskeletal lesions. We believe these biopsies appropriate in selected circumstances but a key factor for appropriate use is an experienced musculoskeletal tumor team with frequent communication to correlate clinical, radiographic, and histologic information for each patient. Level of Evidence Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Clinical Utility of Percutaneous Biopsies of Musculoskeletal Tumors

Abstract: Diagnostic study, level IV.

Cited by 63 publications

References 15 publications

Revisiting CT-Guided Percutaneous Core Needle Biopsy of Musculoskeletal Lesions: Contributors to Biopsy Success

Revisiting CT-Guided Percutaneous Core Needle Biopsy of Musculoskeletal Lesions: Contributors to Biopsy Success

Fine Needle Aspiration for Clinical Triage of Extremity Soft Tissue Masses

Analysis of Nondiagnostic Results after Image-guided Needle Biopsies of Musculoskeletal Lesions

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