Accuracy of CT-Guided Needle Biopsy of Musculoskeletal Neoplasms

Dupuy, Damian E.; Rosenberg, Andrew E.; Punyaratabandhu, Thipachart; Tan, Mann Hong; Mankin, Henry J.

doi:10.2214/ajr.171.3.ajronline_171_3_001

Cited by 209 publications

(136 citation statements)

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“…In our study, two of the three repeat biopsies (lymphoma) were more likely associated with difficulties in obtaining histologic confirmation rather than with failures of the surgical technique. This is in keeping with previous reports, which noted the difficulties in making the diagnosis of round cell tumors [7,8,21]. Without ongoing close scrutiny, the performance of a process may deviate unbeknownst to the care providers participating in that same process.…”

Section: Discussionsupporting

confidence: 90%

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Using the CUSUM Test to Control the Proportion of Inadequate Open Biopsies of Musculoskeletal Tumors

Biau

Weiß

Bhumbra

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Biopsies of musculoskeletal tumors lead to alterations in treatment in almost 20% of cases. Control charts are useful to ensure that a process is operating at a predetermined level of performance, although their use has not been demonstrated in assessing the adequacy of musculoskeletal biopsies. Questions/purposes We therefore (1) assessed the incidence of and the reasons for inadequate musculoskeletal biopsies when following guidelines for performing the procedure; and (2) implemented a process control chart, the CUSUM test, to monitor the proportion of inadequate biopsies. Methods We prospectively studied 116 incisional biopsies. The biopsy was performed according to 10 rules to (1) minimize contamination in the tissues surrounding the tumor; and (2) improve accuracy. A frozen section was systematically performed to confirm that a representative specimen was obtained. Procedures were considered inadequate if: (1) another biopsy was necessary; (2) the biopsy tract was not appropriately placed; and (3) the treatment provided based on the diagnosis from the biopsy was not appropriate. Results Five (4.3%) of the 116 incisional biopsy procedures were considered failures. Three patients required a second repeat open biopsy and two were considered to receive inappropriate treatment. No alarm was raised by the control chart and the performance was deemed adequate over the monitoring period. Conclusions The proportion of inadequate musculoskeletal open biopsies performed at a referral center was low. Using a statistical process control method to monitor the failures provided a continuous measure of the performance.

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Section: Discussionsupporting

confidence: 90%

“…This is similar to findings in other studies. Dupuy et al [7] reported an increase in accuracy for core and needle biopsies when frozen sections were concomitantly used from 88% to 94%. Similarly, Ashford et al [1] in a study of 104 core needle biopsies with systematic intraoperative frozen section reported no major error in diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Using the CUSUM Test to Control the Proportion of Inadequate Open Biopsies of Musculoskeletal Tumors

Biau

Weiß

Bhumbra

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…However, we have to emphasize that the results for the cervical spine in this study were based on a very small group of patients (2/214). There are several reasons why CT-guided biopsy can be unsuccessful, e. g. failure to biopsy the target lesion, failure to collect material sufficient for analysis and inability to make a definitive diagnosis due to nonspecific histological characteristics or the presence of necrosis [4,7,15]. Imaging methods are indispensable in the screening, detection and characterization of lesions of the spine.…”

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confidence: 99%

CT-Guided Percutaneous Spine Biopsy in Suspected Infection or Malignancy: A Study of 214 Patients

Rehm

Veith

Akbar

et al. 2016

Fortschr Röntgenstr

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Zusammenfassung ▼Ziel: Retrospektive Bestimmung der Effektivität und Genauigkeit von CT-gesteuerten perkutanen Biopsien von malignen und entzündlichen Verän-derungen der Wirbelsäule und Bestimmung der Reliabilität der prä-interventionell durchgeführ-ten CT-und MRT-Bildgebung. Abstract ▼Purpose: To retrospectively determine the effectiveness and accuracy of CT-guided percutaneous biopsy of malignant and inflammatory bone lesions of the spine and to assess the reliability of pre-biopsy CT and MRI. Materials and Methods: 214 patients with lesions of the spine, which were suspicious either for being malignant or inflammatory, underwent CT-guided biopsy for pathological and/or microbiological detection. Biopsy samples were sent for histological examination in 128/214 patients, for microbiological analysis in 17/214 patients and for both analyses in 69/214 patients. Retrospectively, the diagnostic accuracy and sensitivity/specificity of the pre-interventional imaging (CT and MRI) were determined. In addition, the influence of the biopsy on subsequent patient management was assessed. Results: The accuracy was 94.4 % for histopathological analysis and 97.7 % for microbiological analysis. In 25 % of cases the microbiological analysis revealed an underlying pathogen that was not significantly affected by pre-biopsy antibiotic therapy. The sensitivity/specificity of the pre-biopsy crosssectional imaging concerning suspected malignancy was 69 %/78 %. For suspected infection, the sensitivity/specificity of pre-biopsy imaging was 81 %/ 44 %. In 52 % of all cases, the biopsy result changed subsequent patient management. Conclusion: Percutaneous CT-guided spine biopsy is a useful and reliable diagnostic procedure to establish a definitive diagnosis but with a relatively low yield of microorganisms in the case of infection.

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“…The diagnostic yield of image guided biopsy in case of musculoskeletal lesions was said to be in the range of 80%-95%. [7][8][9][10] In addition to core needle biopsy, FNAC of bone tumours was another option, added to the biopsy armamentarium by Martin and Ellis in 1930. 11 Limitation of FNAC is that we get cells only; but the diagnosis of many primary bone tumors is by substance produced by the cells i.e.…”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of computed tomography guided biopsy in the diagnosis of primary bone tumors

2017

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Background: Primary bone tumors account for a small yet significant number in the total incidence of tumors. Computed tomography (CT) guided percutaneous core biopsy is a novel yet significant step in the approach towards the diagnosis of bone tumors and is increasingly performed by orthopaedic oncologists around the world. This study is aimed to evaluate the diagnostic accuracy of CT guided biopsy in the diagnosis of primary bone tumors. Methods: Patients who underwent CT guided biopsy and subsequent excision for primary bone tumors from January 2008 to July 2015 were analysed. CT guided biopsy results were compared with post-operative histopathological reports to evaluate its sensitivity and specificity.Results: A total of 161 patients were included in the retrospective study. Among them, 147 were true positives, 7 were false negatives, 6 were true negatives and one was false positive. The sensitivity of CT guided biopsy in the diagnosis of primary bone tumor was 95.4 % with specificity of 85.7% with a diagnostic efficiency of 90.5%. The complication rate was 4.3%.Conclusions: CT guided biopsy is a safe, simple and effective procedure to rule out and rule in the diagnosis of primary bone tumors.

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Accuracy of CT-Guided Needle Biopsy of Musculoskeletal Neoplasms

Cited by 209 publications

References 0 publications

Using the CUSUM Test to Control the Proportion of Inadequate Open Biopsies of Musculoskeletal Tumors

Using the CUSUM Test to Control the Proportion of Inadequate Open Biopsies of Musculoskeletal Tumors

CT-Guided Percutaneous Spine Biopsy in Suspected Infection or Malignancy: A Study of 214 Patients

A retrospective analysis of computed tomography guided biopsy in the diagnosis of primary bone tumors

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