Anatomically Based Guidelines for Core Needle Biopsy of Bone Tumors: Implications for Limb-sparing Surgery

Liu, Patrick T.; Valadez, Scott D.; Chivers, F. Spencer; Roberts, Catherine C.; Beauchamp, C.P.

doi:10.1148/rg.271065092

Cited by 112 publications

(81 citation statements)

References 36 publications

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“…Although resection of the biopsy tract is recommended by numerous authors [5,13,14], neither we nor Oliveira et al [20] could find a study that definitively confirmed the frequency of biopsy tract seeding or that there is increased risk of local recurrence when the biopsy tract is not resected.…”

Section: Introductionmentioning

confidence: 60%

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Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas?

Barrientos-Ruiz

Ortiz‐Cruz

Serrano-Montilla

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background A biopsy is the final step in the diagnosis of sarcomas. Complete resection of the biopsy tract traditionally has been recommended in musculoskeletal oncology guidelines, as that tract is considered potentially seeded with tumor cells. However, to our knowledge, the frequency and implications of contamination of the biopsy tract-specifically with respect to the likelihood of local recurrence-and the factors that affect cell seeding are not well described. Questions/purposes We asked: (1) How often are biopsy tracts contaminated with pathologically detectable tumor cells at the time of tumor resection? (2) What factors, in particular biopsy type (open versus percutaneous), are associated with tumoral seeding? (3) Is biopsy tract contamination associated with local recurrence? Methods This is a retrospective study of a database with patient data collected from a single center between 2000 and 2013. We treated 221 patients with sarcomas. A total of 27 patients (12%) were excluded and 14 (6%) were lost to followup. One hundred eighty patients finally were included in the analysis who either had biopsies at our center (112) or biopsies at outside institutions (68). Of those performed at our center, 15 (13%) were open and 97 (87%) were percutaneous; of those at outside centers, those numbers were 47 (69%) and 21 (31%) respectively. Median followup was 40 months (range, 24-152 months). During the study period, we generally performed percutaneous biopsies as a standard practice for the diagnosis of bone and soft tissue sarcomas and open biopsies were done when the percutaneous procedure failed to provide a histologic characterization. The mean age of the population was 48 years (range, 7-87 years); 60% were male; 42% had bone sarcomas. Nineteen patients had preoperative radiotherapy and 56 had postoperative radiotherapy. Fifty-seven patients received neoadjuvant chemotherapy and 73 had Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution has or waived for the human protocol for this investigation and that all investigations were conducted in conformity with ethical and confidentiality principles of research. This work was performed at the Musculoskeletal Tumor Unit, Orthopaedics and Traumatology Department, at La Paz University Hospital, Madrid, Spain. We determined what proportion of biopsy tracts were contaminated by pathologic analysis of the biopsy tract specimen; during the period in question, our routine practice was to excise the biopsy tract whenever possible at the time of the definitive resection. Using the logistic regression test and Mantel-Haenszel test, we compared open wi...

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Section: Introductionmentioning

confidence: 60%

“…Guidelines recommend biopsy tract resection in the definitive surgery to achieve complete elimination of malignant cells [5,13,14]. To our knowledge, and as reported by Oliveira et al [20], contamination of the tract and the factors that can affect seeding have not been reported.…”

Section: Discussionmentioning

confidence: 84%

Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas?

Barrientos-Ruiz

Ortiz‐Cruz

Serrano-Montilla

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…F-FDG) positron emission tomography (PET)/CT and MRI in a patient with intra-osseous haemangioma in the proximal tibia, who was initially misdiagnosed as having a malignancy based on 18 F-FDG PET/CT. 18 F-FDG PET/CT showed a well-marginated osteolytic lesion with abnormal FDG uptake.…”

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confidence: 99%

PET/CT and MRI of intra-osseous haemangioma of the tibia

Yoo²,

Kim³

et al. 2012

BJR

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ABSTRACT. Intra-osseous haemangioma is a rare, benign neoplasm that usually involves the vertebrae and craniofacial bones. Furthermore, its occurrence in the long bones is extremely rare. We report the findings of fluorine-18-fludeoxyglucose ( F-FDG PET/CT showed a well-marginated osteolytic lesion with abnormal FDG uptake. The mass demonstrated low signal intensity on T 1 weighted MRI. On T 2 weighted images, the lesion appeared as a cluster of high signal intensity lobules and showed strong enhancement on contrast-enhanced T 1 weighted images. Surgical curettage was performed and histopathological examination of the excised tissue confirmed a cavernous haemangioma.

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“…All biopsy procedures, regardless of the site and size of the lesion and the type of needles used, should be performed with strict adherence to anatomic compartments; uninvolved compartments should be avoided by the needle. 6 For patients who have already undergone an operation, the needle approach should be performed on the surgical scar. 3 Complete staging with radiographs, bone scan, CT with contrast medium, and MRI should always be performed before the biopsy procedure for 2 reasons: the reactive changes determined by the biopsy may create difficulty in evaluation of the extension of the tumor and accurate imaging and staging can reveal a site of the disease that is more easy to approach.…”

Section: Biopsy Procedures and Samplingmentioning

confidence: 99%