The Accuracy and Clinical Utility of Intraoperative Frozen Section Analysis in Open Biopsy of Bone

Wallace, Matthew T.; Lin, Patrick P.; Bird, Justin E.; Moon, Bryan S.; Satcher, Robert L.; Lewis, Valerae O.

doi:10.5435/jaaos-d-18-00071

Cited by 17 publications

(13 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sampling error presents as another problem for bone biopsy. A diagnosis was not obtained successfully in 79% of cases reported with CT image-guided core biopsies of musculoskeletal tumors [24], as well as in 47% of open biopsy cases [25,26]. Incorrect diagnosis from tertiary cancer centers also range from 6% to 12% for image-guided core needle biopsies [27].…”

Section: Discussionmentioning

confidence: 99%

Deep learning-based classification of primary bone tumors on radiographs: A preliminary study

Pan

Bao

et al. 2020

eBioMedicine

View full text Add to dashboard Cite

Background: To develop a deep learning model to classify primary bone tumors from preoperative radiographs and compare performance with radiologists. Methods: A total of 1356 patients (2899 images) with histologically confirmed primary bone tumors and preoperative radiographs were identified from five institutions' pathology databases. Manual cropping was performed by radiologists to label the lesions. Binary discriminatory capacity (benign versus not-benign and malignant versus not-malignant) and three-way classification (benign versus intermediate versus malignant) performance of our model were evaluated. The generalizability of our model was investigated on data from external test set. Final model performance was compared with interpretation from five radiologists of varying level of experience using the Permutations tests. Findings: For benign vs. not benign, model achieved area under curve (AUC) of 0894 and 0877 on cross-validation and external testing, respectively. For malignant vs. not malignant, model achieved AUC of 0907 and 0916 on cross-validation and external testing, respectively. For three-way classification, model achieved 721% accuracy vs. 746% and 721% for the two subspecialists on cross-validation (p = 003 and p = 052, respectively). On external testing, model achieved 734% accuracy vs. 693%, 734%, 731%, 679%, and 634% for the two subspecialists and three junior radiologists (p = 014, p = 089, p = 093, p = 002, p < 001 for radiologists 1À5, respectively). Interpretation: Deep learning can classify primary bone tumors using conventional radiographs in a multiinstitutional dataset with similar accuracy compared to subspecialists, and better performance than junior radiologists.

show abstract

Section: Discussionmentioning

confidence: 99%

Deep learning-based classification of primary bone tumors on radiographs: A preliminary study

Pan

Bao

et al. 2020

eBioMedicine

View full text Add to dashboard Cite

show abstract

“…In such cases, bone biopsy may be essential to confirm the diagnosis. The accuracy of open and needle bone biopsy was 95% and 70-90%, respectively [4,5]. In case 1 with a dissociation between lymph node and bone lesions, bone biopsy was helpful to confirm the unresponsiveness to GC therapy and abandon the first-line treatment.…”

Section: Discussionmentioning

confidence: 98%

Two cases of osteoblastic bone metastasis from muscle-invasive bladder cancer with discrepancy in response to chemotherapy: problems and limitations of bone biopsy

et al. 2020

View full text Add to dashboard Cite

We report two cases of muscle-invasive bladder cancer (MIBC) with increasing multiple osteoblastic bone lesions but shrinking other lesions in response to chemotherapy. Case 1 had MIBC and received radical cystectomy followed by adjuvant gemcitabine plus cisplatin chemotherapy (GC). Three years after, follow computed tomography (CT) showed development of multiple lymph node metastasis, and then we performed GC as a first-line systemic chemotherapy. After two cycles of GC, CT showed de novo multiple osteoblastic lesions although metastatic lymph nodes were shrunk. Biopsy of the sternum revealed metastatic urothelial carcinoma. Case 2 had MIBC with multiple osteoblastic lesions on CT and bone scintigraphy, which was initially diagnosed as cT3bN0M1. After one cycle of GC, the number of osteoblastic lesions obviously increased although bladder tumor was regressed. Since the clinical course was unusual, biopsy of the clavicle was done. The histological diagnosis was benign osteoblastic bone disease, then the clinical diagnosis was revised to non-metastatic MIBC, and radical cystectomy was performed. Ten months after surgery, the patients complained worsening backache and CT showed increase in number of osteoblastic lesions. Eventually, ilium biopsy revealed bone metastasis of urothelial carcinoma. In case of atypical finding and unusual clinical course, biopsy of suspected metastatic lesion may be informative although adequate sampling should be secured.

show abstract

“…A solitary bone lesion must be considered a primary bone tumour until proven otherwise [12]. To reduce the amount of operative interventions, a frozen section biopsy can be taken at the beginning of an operation to confirm that the lesion not a primary bone tumor, and then definitive fixation can be undertaken [13,14]. In the circumstances when the lesion is not carcinoma, or a primary bone tumour cannot be ruled out, the wound should be closed and fixation or prophylactic stabilization should be delayed until a definitive diagnosis is reached [14].…”

Section: Preoperative Assessmentmentioning

confidence: 99%

The Surgical Management of Proximal Femoral Metastases: A Narrative Review

2021

View full text Add to dashboard Cite

The proximal femur is a common location for the development of bony metastatic disease. Metastatic bone disease in this location can cause debilitating pain, pathologic fractures, reduced quality of life, anemia or hypercalcemia. A thorough history, physical examination and preoperative investigations are required to ensure accurate diagnosis and prognosis. The goals of surgical management is to provide pain relief and return to function with a construct that provides stability to allow for immediate weightbearing. Current surgical treatment options include intramedullary nailing, hemiarthroplasty or total hip arthroplasty and endoprosthetic reconstructions. Oligometastatic renal cell carcinoma must be given special consideration as tumor resection and reconstruction has survival benefit. Both tumor and patient characteristics must be taken into account before deciding on the appropriate surgical intervention.

show abstract

The Accuracy and Clinical Utility of Intraoperative Frozen Section Analysis in Open Biopsy of Bone

Cited by 17 publications

References 15 publications

Deep learning-based classification of primary bone tumors on radiographs: A preliminary study

Deep learning-based classification of primary bone tumors on radiographs: A preliminary study

Two cases of osteoblastic bone metastasis from muscle-invasive bladder cancer with discrepancy in response to chemotherapy: problems and limitations of bone biopsy

The Surgical Management of Proximal Femoral Metastases: A Narrative Review

Contact Info

Product

Resources

About