Image Guided Core Needle Biopsy of Musculoskeletal Lesions: Are Nondiagnostic Results Clinically Useful?

Abstract

Nondiagnostic core needle biopsy results in musculoskeletal lesions are not entirely useless. At times, they can be supportive of benign processes and can help avert unnecessary surgical procedures.

Ultrasound-guided bone lesions biopsies - a systematic review

“…These results were useful in clinical practice in around 60% of the cases, and should not be considered flaws [60]. In a study it was showed that they were helpful mostly in asymptomatic versus symptomatic lesions (84% vs 55%), non-aggressive versus aggressive (72% vs 45%) and in case evaluated pre-biopsy as "likely to be benign" versus "suspicious for malignancy" (74% vs 40%) [60].…”

“…US was mostly used for the first two types of BL (lytic) [42] when biopsy was performed with cutting or fine needles. Sclerotic lesions were associated with the lowest diagnostic yield indifferent of the guiding method (US or CT), and were biopsied with trephine needles -Jamshidi [48], Ostycut [35,42], Bonopty [60] -allowing drilling in the bone cortex, followed by cutting biopsy or aspiration with coaxial technique. For the last type of BL (without alteration of the bone cortex) biopsy was performed also with the trephine needles usually under radiological guidance, but also with US guidance in some studies [42].…”

“…For the last type of BL (without alteration of the bone cortex) biopsy was performed also with the trephine needles usually under radiological guidance, but also with US guidance in some studies [42]. Bone biopsy of benign lesions had a lower accuracy compared with a biopsy from malignant lesions [60].…”

“…The rate of non-diagnostic biopsies was low (5-31%), being influenced by a series of technical factors such as: number of passages, type of needle, localization of the lesion, but the data derived mostly from CT-guided biopsies [48,60,62]. These results were useful in clinical practice in around 60% of the cases, and should not be considered flaws [60].…”

“…The rate of non-diagnostic biopsies was low (5-31%), being influenced by a series of technical factors such as: number of passages, type of needle, localization of the lesion, but the data derived mostly from CT-guided biopsies [48,60,62]. These results were useful in clinical practice in around 60% of the cases, and should not be considered flaws [60]. In a study it was showed that they were helpful mostly in asymptomatic versus symptomatic lesions (84% vs 55%), non-aggressive versus aggressive (72% vs 45%) and in case evaluated pre-biopsy as "likely to be benign" versus "suspicious for malignancy" (74% vs 40%) [60].…”