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In 65 patients an ultrasonographically guided needle biopsy was performed for histologic diagnosis of benign and malignant soft tissue and bone tumors. On the basis of the histopathologic findings, a final diagnosis could be made in 54 cases after sonographically guided needle biopsy of the soft tissue tumor component. In addition, tumor grouping was possible in seven cases; however, due to the small volume of the biopsy specimen, further tumor differentiation proved to be unsuccessful. A definite diagnosis was not possible in four patients, who had mainly cystoid tumors; however, malignancy could be ruled out in three of these cases. The decisive advantage of the ultrasonographically guided needle biopsy procedure over what is known as a blind tumor biopsy is that the biopsy needle can be positioned exactly by means of imaging control. The ultrasound screen enables the user to monitor the biopsy procedure; multiple biopsies of different parts of the tumor soft tissue component can be performed using a single needle tract. No complications occurred in our study. Because of the far-reaching consequences of ultrasonographically guided needle biopsy, this type of procedure should be performed only at tumor centers.

The strength of bone is determined not only by bone density but also by structure. Therefore, quantification of the structure in radiographs by texture parameters may result in a better prediction of fracture risk. Since in radiographs density and structure are strongly correlated, the predictive power of texture parameters should be corrected for the influence of BMD to determine the additional information conveyed by these parameters. In this study, we evaluated the predictive power of various texture parameters based on the Grey-Level Dependence Method and the Morphological Gradient Method. This study was performed on 67 vertebrae obtained from 20 male and 12 female human cadaver thoracolumbar spines. BMD and area of the vertebral body were determined from QCT images and texture parameters were derived from direct magnification (DIMA) radiographs. The fracture force, measured under conditions simulating the in vivo situation, was corrected with the area of the vertebra to yield the fracture stress (FS). Results of the study indicate that BMD correlates significantly with FS r = 0.82 (P < 0. 001, n = 24) and r = 0.94 (P < 0.001, n = 43) for female and male vertebrae, respectively. Correlation coefficients of the investigated texture parameters were as high as 0.80 (P < 0.001) and 0.67 (P < 0.001) for the female and male vertebrae, respectively. Multiple regression analysis showed that in female vertebrae, the addition of one texture parameter to BMD results in a better prediction of strength. The multiple correlation coefficient was 0. 87 (P < 0.001) in this case. In male vertebrae, BMD was the best predictor of fracture stress. These results suggest that texture parameters, as measured in magnification radiographs, can predict bone strength. Whereas in all cases BMD is the best single predictor of bone strength, for women texture parameters contain useful additional information.

The advantages of the ultrasonic examination are the immediate availability, the avoidance of radiation and the visualization of movements with dynamic examinations. In contrast to X-ray examination the ultrasonic investigation can provide useful additional information on soft tissue structures.

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