Percutaneous CT-Guided Bone Biopsies: Indications, Feasibility and Diagnostic Yield in the Different Skeletal Sites—From the Skull to the Toe

Abstract

CT-guided bone biopsies are currently the diagnostic tool of choice for histopathological (and microbiological) diagnoses of skeletal lesions. Several research works have well-demonstrated their safety and feasibility in almost all skeletal regions. This comprehensive review article aims at summarizing the general concepts in regard to bone biopsy procedures, current clinical indications, the feasibility and the diagnostic yield in different skeletal sites, particularly in the most delicate and difficult-to-reach ones. The choice of the correct imaging guidance and factors affecting the diagnostic rate, as well as possible complications, will also be discussed. Since the diagnostic yield, technical difficulties, and complications risk of a CT-guided bone biopsy significantly vary depending on the different skeletal sites, subdivided analyses of different anatomical sites are provided. The information included in the current review article may be useful for clinicians assisting patients with possible bone neoplasms, as well as radiologists involved in the imaging diagnoses of skeletal lesions and/or in performing bone biopsies.

Imaging of Spondylodiscitis: A Comprehensive Updated Review—Multimodality Imaging Findings, Differential Diagnosis, and Specific Microorganisms Detection

“…Indeed, CT guidance is superior to fluoroscopic guidance, especially for small spinal lesions. Most importantly, it can guide procedures in all skeletal areas (including spinal segments) (Figure 8) [67]. Ultrasound guidance is used in the spine only in selected cases, especially if a large paravertebral abscess is present [68].…”

“…Moreover, it is known that several factors are associated with the highest diagnostic yield on CT-guided biopsy for spondylodiscitis assessment and in general [67,71]; the main ones are summarized in Table 3.…”