Contribution of percutaneous biopsy to the definite diagnosis in patients with suspected bone tumor

Vieillard, Marie-Hélène; Boutry, Nathalie; Chastanet, P; Duquesnoy, B; Cotten, Anne; Cortet, Bernard

doi:10.1016/j.jbspin.2004.03.008

Cited by 43 publications

(27 citation statements)

References 21 publications

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“…The calculation of diagnostic accuracy and diagnostic yield was made using the following definitions that have been used in previous published studies in the literature [5,6,9]: Only cases with surgical histology were used in calculation of diagnostic accuracy [9]. While calculating the diagnostic accuracy, we included as true-positives, results in which needle biopsy results were correct with regards to malignancy but not necessarily with regards to exact histological features (reasonable match); i.e.…”

Section: Categorymentioning

confidence: 99%

“…While calculating diagnostic yield, all cases where needle biopsy provided a diagnosis allowing further appropriate management were included as true-positives in the numerator [5]. This included needle biopsy results reasonably matching with surgical histology and Category 1 and 2 diagnoses without surgical histology, but which allowed appropriate further management.…”

Section: Categorymentioning

confidence: 99%

“…One study looking exclusively at the diagnostic accuracy of percutaneous biopsy of sclerotic bone lesions reported high positive and negative predictive values [4]. Lytic lesions are reported to have a higher diagnostic yield than sclerotic lesions and biopsy of an extraosseous soft tissue component provides higher diagnostic yield than bone sampling [5,6]. Intramedullary lytic bone lesions form a large subset of bone lesions that are biopsied under image guidance and may or may not be associated with extraosseous soft tissue components.…”

Section: Introductionmentioning

confidence: 99%

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Image-guided percutaneous biopsy of intramedullary lytic bone lesions: utility of aspirated blood clots

et al. 2006

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The diagnostic value of aspirating blood clots while performing percutaneous biopsy of intramedullary lytic bone lesions was assessed. This was a retrospective analysis of 400 patients with intramedullary lytic bone lesions who underwent image-guided needle biopsy. The nature of the specimens obtained was noted from the histopathology records. In 83 (20.8%) of the 400 patients, the specimen obtained was either blood clot only or essentially blood clot with only tiny fragments of bone or soft tissue. Lesional tissue was present on needle biopsy specimens in 65 (78.3%) of the 83 cases, while in 18 (21.7%) cases no lesional tissue was obtained. In 24 of the 83 cases, there was no surgical histological diagnosis available. In the 59 cases where surgical histological diagnosis was available for comparison, the diagnostic accuracy for needle biopsy was 73%. Percutaneous biopsy provided the diagnosis allowing appropriate further management in 62 cases, for an overall diagnostic yield of 75%. The results of our study show a sufficiently good diagnostic value in obtaining blood clots as to necessitate routine attempts at obtaining such material while performing percutaneous biopsy of intramedullary lytic bone lesions.

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Section: Categorymentioning

confidence: 99%

Section: Categorymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Image-guided percutaneous biopsy of intramedullary lytic bone lesions: utility of aspirated blood clots

et al. 2006

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“…Most likely it is more difficult to retrieve an adequate sample from sclerotic bone lesions due to the consistency. Sclerotic lesions are mainly composed of eburnated bone with only small areas of bone marrow with a few cell clusters which can hinder analysis [13]. Kattaparum et al reported minor success when smaller-sized biopsy systems were used [14].…”

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confidence: 99%

CT-Guided Percutaneous Spine Biopsy in Suspected Infection or Malignancy: A Study of 214 Patients

Rehm

Veith

Akbar

et al. 2016

Fortschr Röntgenstr

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Zusammenfassung ▼Ziel: Retrospektive Bestimmung der Effektivität und Genauigkeit von CT-gesteuerten perkutanen Biopsien von malignen und entzündlichen Verän-derungen der Wirbelsäule und Bestimmung der Reliabilität der prä-interventionell durchgeführ-ten CT-und MRT-Bildgebung. Abstract ▼Purpose: To retrospectively determine the effectiveness and accuracy of CT-guided percutaneous biopsy of malignant and inflammatory bone lesions of the spine and to assess the reliability of pre-biopsy CT and MRI. Materials and Methods: 214 patients with lesions of the spine, which were suspicious either for being malignant or inflammatory, underwent CT-guided biopsy for pathological and/or microbiological detection. Biopsy samples were sent for histological examination in 128/214 patients, for microbiological analysis in 17/214 patients and for both analyses in 69/214 patients. Retrospectively, the diagnostic accuracy and sensitivity/specificity of the pre-interventional imaging (CT and MRI) were determined. In addition, the influence of the biopsy on subsequent patient management was assessed. Results: The accuracy was 94.4 % for histopathological analysis and 97.7 % for microbiological analysis. In 25 % of cases the microbiological analysis revealed an underlying pathogen that was not significantly affected by pre-biopsy antibiotic therapy. The sensitivity/specificity of the pre-biopsy crosssectional imaging concerning suspected malignancy was 69 %/78 %. For suspected infection, the sensitivity/specificity of pre-biopsy imaging was 81 %/ 44 %. In 52 % of all cases, the biopsy result changed subsequent patient management. Conclusion: Percutaneous CT-guided spine biopsy is a useful and reliable diagnostic procedure to establish a definitive diagnosis but with a relatively low yield of microorganisms in the case of infection.

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“…A general review of 108 suspected bone malignancies performed by Vieillard et al demonstrated a diagnostic yield of 100% for metastatic disease compared with 83% for primary tumors and 58% for hematological malignancies; this article also noted significantly less yield of vertebral lesions (66%) compared with peripheral lesions (85%). 22 Another general review by Cronin et al of new suspicious bone lesions in patients with a known primary carcinoma revealed the probability of only 2% for lesions other than metastatic disease. 6 A cursory comparison of our own cases of known primary malignancy with suspicion for metastatic vertebral disease also suggested a high correlation.…”

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confidence: 99%

Computed tomography–guided percutaneous biopsy for vertebral neoplasms: a department's experience and hybrid biopsy technique to improve yield

Garg

Kosmas

Josan

et al. 2016

FOC

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OBJECTIVE Recent articles have identified the poor diagnostic yield of percutaneous needle biopsy for vertebral osteomyelitis. The current study aimed to confirm the higher accuracy of CT-guided spinal biopsy for vertebral neoplasms and to identify which biopsy technique provides the highest yield. METHODS Over a 9-year period, the radiology department at University Hospitals Case Medical Center performed 222 CT-guided biopsies of vertebral lesions, of which clinicians indicated a concern for vertebral neoplasms in 122 patients. A retrospective chart review was performed to confirm the higher sensitivity of the percutaneous intervention for vertebral neoplasms. RESULTS A core sample was obtained for all 122 biopsies of concern (100.0%). Only 6 cases (4.9%) were reported as nondiagnostic per histological sampling, and 12 cases (9.8%) were negative for disease. The question of vertebral neoplastic involvement warrants follow-up, and the current study was able to determine the subsequent diagnosis of each lesion. Of the 122 total, 94 (77.0%) core samples provided true-positive results, and the sensitivity of core biopsy measured 87.9%. The technical approach did not demonstrate any significant difference in diagnostic yield. However, when the vertebral cortex was initially pierced with a coaxial bone biopsy system and subsequently a 14-gauge spring-loaded cutting biopsy needle was coaxially advanced into lytic lesions, 14 true positives were obtained with a corresponding sensitivity of 100.0%. CONCLUSIONS This study confirms the higher sensitivity of image-guided percutaneous needle biopsy for vertebral neoplasms. In addition, it demonstrates how the use of a novel cutting needle biopsy approach, performed coaxially through a core biopsy track, provides the highest yield.

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Contribution of percutaneous biopsy to the definite diagnosis in patients with suspected bone tumor

Cited by 43 publications

References 21 publications

Image-guided percutaneous biopsy of intramedullary lytic bone lesions: utility of aspirated blood clots

Image-guided percutaneous biopsy of intramedullary lytic bone lesions: utility of aspirated blood clots

CT-Guided Percutaneous Spine Biopsy in Suspected Infection or Malignancy: A Study of 214 Patients

Computed tomography–guided percutaneous biopsy for vertebral neoplasms: a department's experience and hybrid biopsy technique to improve yield

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