Performance of Computed Tomography-Guided Spine Biopsy for the Diagnosis of Malignancy and Infection

Harris, Lauren; Rajashekar, Devika; Sharma, Puneet; David, Karoly M.

doi:10.1093/ons/opab148

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…Rehm et al have found that CT-guided spine biopsy has an accuracy of 94.4% for histopathological analysis and 97.7% for microbiological analysis [ 14 ]. However, the clinical application of CT-guided spine biopsy may still be limited by several factors, such as intolerance, time consuming, and risk of radiation exposure [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

C-arm Fluoroscopy-Guided Percutaneous Needle Biopsy for the Diagnosis of Spinal Infection: A Study of 203 Consecutive Patients

Fei

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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C-arm fluoroscopy-guided percutaneous needle biopsy (PNB) is a commonly used biopsy method, which shows similar diagnostic outcomes to CT-guided biopsy. This study aimed to evaluate the diagnostic value of C-arm fluoroscopy-guided percutaneous needle biopsy (PNB) for spinal infection. A total of 30 male and 73 female patients with suspected spinal infection were enrolled. Among enrolled patients, the spinal lesion was mainly located in the thoracic (T3-T12, 48.28%) and lumbar vertebra (L1-L5, 46.80%), and T12 was the most frequently involved site. C-arm fluoroscopy-guided PNB was performed for the isolation of biopsy samples in these patients. The overall detection rate of pathological changes in bone tissues was 94.1% (191/203), including 92 granulomata with caseous necrosis, 81 inflammatory tissues, 18 tumor tissues, and 12 bone tissues without visible pathological changes. After excluding the tumors, the detection rate of pathogenic microorganisms in liquid tissues was 50.27% (93/185), including 68 Mycobacterium tuberculosis, and 25 other microorganisms. Spinal tuberculosis was diagnosed in 118 (58%) cases, and nonspecific spinal infection with microorganisms other than Mycobacterium tuberculosis was diagnosed in 25 (12.7%) cases. Definite diagnosis was not determined in the left 42 (20.5%) patients with neither positive pathological nor pathogenic results. C-arm fluoroscopy-guided PNB is effective in the detection of pathological changes and pathogenic microorganisms, which is a practical approach for the diagnosis of spinal infection with high accuracy.

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Section: Introductionmentioning

confidence: 99%

C-arm Fluoroscopy-Guided Percutaneous Needle Biopsy for the Diagnosis of Spinal Infection: A Study of 203 Consecutive Patients

Fei

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…It is important to note that imaging findings should always be interpreted in conjunction with clinical history, laboratory results and other diagnostic tests to arrive at an accurate diagnosis. In some cases, further invasive procedures such as biopsy or culture may be necessary for definitive diagnosis [74][75][76].…”

Section: Differentiating Features On Mrimentioning

confidence: 99%

Diagnostic Approach and Differences between Spinal Infections and Tumors

Compagnone,

Cecchinato,

Pezzi

et al. 2023

Diagnostics

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Study design: A systematic review of the literature about differential diagnosis between spine infection and bone tumors of the spine. Background and Purpose: The differential diagnosis between spine infection and bone tumors of the spine can be misled by the prevalence of one of the conditions over the other in different areas of the world. A review of the existing literature on suggestive or even pathognomonic imaging aspects of both can be very useful for correctly orientating the diagnosis and deciding the most appropriate area for biopsy. The purpose of our study is to identify which imaging technique is the most reliable to suggest the diagnosis between spine infection and spine bone tumor. Methods: A primary search on Medline through PubMed distribution was made. We identified five main groups: tuberculous, atypical spinal tuberculosis, pyogenic spondylitis, and neoplastic (primitive and metastatic). For each group, we evaluated the commonest localization, characteristics at CT, CT perfusion, MRI, MRI with Gadolinium, MRI diffusion (DWI) and, in the end, the main features for each group. Results: A total of 602 studies were identified through the database search and a screening by titles and abstracts was performed. After applying inclusion and exclusion criteria, 34 articles were excluded and a total of 22 full-text articles were assessed for eligibility. For each article, the role of CT-scan, CT-perfusion, MRI, MRI with Gadolinium and MRI diffusion (DWI) in distinguishing the most reliable features to suggest the diagnosis of spine infection versus bone tumor/metastasis was collected. Conclusion: Definitive differential diagnosis between infection and tumor requires biopsy and culture. The sensitivity and specificity of percutaneous biopsy are 72% and 94%, respectively. Imaging studies can be added to address the diagnosis, but a multidisciplinary discussion with radiologists and nuclear medicine specialists is mandatory.

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“…CT-guided percutaneous needle biopsy is generally considered safe and effective, and there is a low risk of complications such as bleeding, infection, nerve damage, or damage to nearby organs [ 2 , 3 ]. Moreover, CT guidance provides a better 3D orientation and handling capacity of the area of interest during biopsy [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Factors affecting the success of CT-guided core biopsy of musculoskeletal lesions with a 13-G needle

Gataa,

Inci,

Szaro

et al. 2023

Skeletal Radiol

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Objective To determine the value of CT-guided bone core biopsy and investigate factors that affect diagnostic yield and biopsy outcome. Materials and methods The single-centre retrospective analysis included 447 patients who had CT-guided core biopsy with a 13-G needle (Bonopty®) from January 2016 to December 2021. Histological results or ≥ 6 months of clinical and radiological follow-up served as outcome references. A successful biopsy was classified as “diagnostic” when a definitive diagnosis was made and “adequate” when only the malignant or benign nature of the tumour could be determined. Biopsies were “nondiagnostic” when the nature of the lesion could not be determined. The occult lesions were defined as not seen on CT but visible on other modalities. Results In 275 (62%) females and 172 (38%) males, the overall success rate was 85% (383 biopsies), with 314 (70%) diagnostic biopsies and 69 (15%) adequate biopsies. There was no relationship between biopsy success and the localisation of the lesion, length of biopsy material, or number of biopsy attempts. The lesions’ nature had a statistically significant effect on biopsy success with lytic and mixed lesions having the highest success rate. Occult lesions had the lowest success rate. Conclusion CT-guided bone core biopsy is an effective method in the workup of musculoskeletal diseases with the highest success rate in lytic and mixed lesions. No apparent relationship was found between biopsy success and biopsy length, number of attempts, or localisation of the lesion.

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Performance of Computed Tomography-Guided Spine Biopsy for the Diagnosis of Malignancy and Infection

Cited by 5 publications

References 26 publications

C-arm Fluoroscopy-Guided Percutaneous Needle Biopsy for the Diagnosis of Spinal Infection: A Study of 203 Consecutive Patients

C-arm Fluoroscopy-Guided Percutaneous Needle Biopsy for the Diagnosis of Spinal Infection: A Study of 203 Consecutive Patients

Diagnostic Approach and Differences between Spinal Infections and Tumors

Factors affecting the success of CT-guided core biopsy of musculoskeletal lesions with a 13-G needle

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