Percutaneous needle biopsy of musculoskeletal lesions. 2. Cost-effectiveness.

Fraser-Hill, Margaret; Renfrew, Donald L.; Hilsenrath, Peter E.

doi:10.2214/ajr.158.4.1546598

Cited by 92 publications

(42 citation statements)

References 11 publications

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“…In the evaluation of primary musculoskeletal neoplasms, the cost-benefit ratio of core-needle biopsy appears to be favorable (2,6). A needle biopsy can be performed expeditiously, and, in cases of a large mass, imaging guidance may not be essential (2).…”

Section: Discussionmentioning

confidence: 99%

Primary Musculoskeletal Neoplasms: Effectiveness of Core-Needle Biopsy

Yao¹,

Nelson²,

Seeger³

et al. 1999

Radiology

140

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PURPOSE:To analyze the effectiveness of core-needle biopsy for evaluation of possible primary musculoskeletal neoplasms, which often are evaluated with open biopsy. MATERIALS AND METHODS:Core-needle biopsy was performed at a tertiary care institution in 141 patients suspected of having a mesenchymal neoplasm. In 85 patients, the lesion was in soft tissue; in 56 patients, the lesion was in bone. Eighty-nine patients had a malignant lesion, and 52 had a benign lesion. Twentyeight patients had undergone previous surgery. RESULTS:In 105 (74%) patients, core-needle biopsy results were concordant with results from specimens subsequently obtained at surgery with respect to tumor histologic features and grade, or they provided sufficient diagnostic information to obviate surgery. In 36 (26%) patients, inaccurate core-needle biopsy results were obtained: In nine, results were imprecise about exact histologic features; in three, results were correct about histologic features but incorrect about tumor grade. In 25 (18%) patients, open biopsy was performed after core-needle biopsy. The accuracy and rate of performance of open biopsy for soft-tissue lesions were not significantly different from those for bone lesions. CONCLUSION:Percutaneous core-needle biopsy can be an effective alternative to open biopsy in the evaluation of possible mesenchymal neoplasms of either bone or soft tissue. Needle biopsy of such lesions, however, is best performed as part of a multidisciplinary team approach to tumor management.

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Section: Discussionmentioning

confidence: 99%

Primary Musculoskeletal Neoplasms: Effectiveness of Core-Needle Biopsy

Yao¹,

Nelson²,

Seeger³

et al. 1999

Radiology

140

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“…Compared to open biopsy, closed biopsy has advantages including less morbidity, easy and quick execution, safety and absence of significant complications related to the procedure, precise location and, it is also cost effective [44][45][46][47][48]. Furthermore it has a positive influence in surgery planning and in the clinical outcome [49,50].…”

Section: Interventional Proceduresmentioning

confidence: 99%

Imaging findings of Pott’s disease

Rivas-Garcia¹,

et al. 2012

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Tuberculosis (TB) continues to be an important public health problem in developed countries especially in deprived socioeconomic groups, older people, immunocompromised patients, drug-therapy resistant cases and the immigrant population. The spine is the most frequent location of musculoskeletal TB. The wide range of clinical presentations results in difficulties and delays in diagnosis. Advanced disease mimics other infections and malignancy. The diagnosis of spinal infections relies on three main factors: clinical symptoms, imaging and bacteriological culture. Advanced imaging such as Magnetic Resonance Imaging (MRI), Multidetector Computed Tomography (MDCT) and Fluor18-Deoxiglucose Positron Emission Tomography combined with CT (F-18 FDG PET-CT) demonstrate lesion extent, serve as guide for biopsy with aspiration for culture, assist surgery planning and contribute to follow-up. Diagnosis of TB cannot be established solely on the basis of clinical tests or imaging findings and biopsy may be required. Differential diagnosis between tuberculous and pyogenic spondylitis is of clinical importance, but may be difficult on the basis of radiological findings alone. Findings not pathognomonic but favoring tuberculous etiology include: slow progression of lesions with late preservation of disk space, involvement of several contiguous segments, large intraosseous and paraspinal abscesses containing calcifications, and body collapse with kyphotic deformity. In this essay the highlights of TB imaging are reviewed through published literature. In addition, we review retrospectively the radiological findings of 48 patients with tuberculous spondylitis treated from 1993 to 2010. There were 23 male and 25 female patients with a mean age of 53 years.

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“…There also is less risk of infection, hematoma, and postoperative fracture [1,13,18,19,31]. The main limitation pertains to the amount of tissue that can be obtained compared with an open biopsy, which may not yield an accurate diagnosis [9,10,13,35].…”

Section: Discussion and Treatmentmentioning

confidence: 99%