Safety of CT-Guided Bone Marrow Biopsy in Thrombocytopenic Patients: A Retrospective Review

Liu, Bo; Limback, Joseph; Kendall, Melissa; Valente, Michael; Armaly, Jamil; Grekoski, Vincent; Pinizzotto, Alex; Burt, Jeremy R.; Ward, Thomas J.

doi:10.1016/j.jvir.2017.08.009

Cited by 16 publications

(8 citation statements)

References 24 publications

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“…The patients in this study were previously studied to assess the impact of platelet count on risk of hemorrhagic complication. 15 Although the biopsies were performed in a hospital setting, the study population included both inpatients and outpatients.…”

Section: Patient Selectionmentioning

confidence: 99%

Safety and Technical Success of CT-Guided Bone Marrow Biopsy in Obese Patients

Manchec

Limback

Liu

et al. 2020

J Clin Interv Radiol ISVIR

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Purpose Obesity can make bone marrow biopsy using manual landmarks as guidance technically challenging. This retrospective review was performed to assess the safety and technical success of performing bone marrow biopsies with computed tomography (CT)–guidance in obese patients. Materials and Methods This single-institution, retrospective study included 1,016 CT-guided bone marrow biopsies performed between 2009 and 2016. Thirty-four percent (n = 348) were performed in patients with a body mass index (BMI) of 30 kg/m2 or greater, and 7% (n = 75) were performed in patients with a BMI greater than 40 kg/m2. Demographic information, BMI, and complications were reviewed. The primary endpoint was technical success and procedurally related hemorrhagic complication. The electronic medical record was reviewed to identify procedural related hemorrhagic complications, Common Terminology Criteria for Adverse Events (CTCAE) Grade 3 or above. The complication rates in obese patients were compared with patients with a BMI less than 30 kg/m2. Results Biopsy was successfully performed in all patients. No biopsies resulted in a CTCAE Grade 3 or above complication. There was no difference in complication rate (0%) based on BMI. For patients with a BMI < 30 kg/m2, BMI ≥ 30 kg/m2, and BMI > 40 kg/m2, complications rates were 0% (95% confidence interval [CI]: 0–0.4%), 0% (95% CI: 0–0.9%), and 0% (95% CI: 0–4%), respectively. Conclusions CT-guided bone marrow biopsy in obese patients can be performed with a high rate of technical success and is safe. If patient body habitus limits the ability to palpate physical landmarks needed to perform bone marrow biopsy without image guidance, CT-guided bone marrow biopsy should be considered.

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Section: Patient Selectionmentioning

confidence: 99%

Safety and Technical Success of CT-Guided Bone Marrow Biopsy in Obese Patients

Manchec

Limback

Liu

et al. 2020

J Clin Interv Radiol ISVIR

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“…However, two studies showed that the significant bleeding in imaging-guided biopsies is a rare and unusual complication even in cases of thrombocytopenia. 23,24 Liu et al 23 performed a retrospective study including an imaging-guided biopsy of bone marrow in 981 patients with normal and low platelet count, focusing on the postprocedural hemorrhage. There was a hemorrhagic complication rate of 0% in the group with the low platelet count.…”

Section: Indications and Contraindicationsmentioning

confidence: 99%

Percutaneous Imaging-Guided versus Open Musculoskeletal Biopsy: Concepts and Controversies

Nikodinovska

Ivanoski

Samardziski

et al. 2020

Semin Musculoskelet Radiol

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Bone and soft tissue tumors are a largely heterogeneous group of tumors. Biopsy of musculoskeletal (MSK) tumors is sometimes a challenging procedure. Although the open biopsy is still considered the gold standard for the biopsy of MSK lesions, core needle biopsy can replace it in most cases, with similar accuracy and a low complication rate. The biopsy should be performed in a tertiary sarcoma center where the multidisciplinary team consists of at minimum a tumor surgeon, an MSK pathologist, and an MSK radiologist who can assess all steps of the procedure. Several factors can influence the success of the biopsy including the lesion characteristics, the equipment, and the method used for the procedure. This review highlights some of the important aspects regarding the biopsy of the MSK tumors, with special attention to imaging a guided core needle biopsy and highlighting some of the recent advancements and controversies in the field.

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“…1-3). [1][2][3][4] Additionally, molecular analysis of malignant tumors is very important for personalized cancer treatment. 5 Absolute contraindications of image-guided percutaneous bone biopsies are rare and include incomplete imaging of the lesion prior to biopsy, inaccessible sites, lack of a safe biopsy path, soft-tissue infection that poses the underlying bone to a high risk of contamination, incomplete information regarding definite surgical excision route, uncooperative or unwilling/unable to provide consent patient, and uncorrected bleeding diathesis.…”

Section: Indications and Contraindicationsmentioning

confidence: 99%

“…Percutaneous, image-guided musculoskeletal biopsy, due to its minimal invasive nature when compared with open surgical biopsy, is a safe and effective technique which is widely used in many institutions as the primary method to acquire tissue and bone samples for histopathological and molecular analysis of a lesion, for recurrence prediction in curative cases (which can assist in the treatment stratification, identification, and validation of new targets), or for culturing and antibiogram testing (in cases of infection). [1][2][3][4][5] Percutaneous biopsies obviate the risk of destabilizing an already diseased spinal or peripheral skeleton segment (which can occur with open biopsies),…”

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confidence: 99%

Bone and Soft-Tissue Biopsies: What You Need to Know

Filippiadis

Charalampopoulos

Mazioti

et al. 2018

Semin intervent Radiol

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Percutaneous, image-guided musculoskeletal biopsy, due to its minimal invasive nature, when compared with open surgical biopsy, is a safe and effective technique which is widely used in many institutions as the primary method to acquire tissue and bone samples. Indications include histopathologic and molecular assessment of a musculoskeletal lesion, exclusion of malignancy in a bone/vertebral fracture, examination of bone marrow, and infection investigation. Preprocedural workup should include both imaging (for lesion assessment and staging) and laboratory (including coagulation tests and platelet count) studies. In selected cases, antibiotic prophylaxis should be administered before the biopsy. Core needle biopsy of musculoskeletal lesions has a diagnostic accuracy that ranges from 66 to 98% with higher diagnostic yield for lytic, large-size, malignant lesions and when multiple and long specimens are obtained. Reported complication rates range between 0 and 10% and usually do not exceed 5%, with a suggested threshold of 2%. The purpose of this review article is to illustrate the technical aspects, the indications, and the methodology of percutaneous image-guided bone biopsy that will assist the interventional radiologist to perform these minimal invasive techniques.

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Safety of CT-Guided Bone Marrow Biopsy in Thrombocytopenic Patients: A Retrospective Review

Cited by 16 publications

References 24 publications

Safety and Technical Success of CT-Guided Bone Marrow Biopsy in Obese Patients

Safety and Technical Success of CT-Guided Bone Marrow Biopsy in Obese Patients

Percutaneous Imaging-Guided versus Open Musculoskeletal Biopsy: Concepts and Controversies

Bone and Soft-Tissue Biopsies: What You Need to Know

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