CT-guided Biopsy for Musculoskeletal Lesions

Mavrogenis, Andreas F.; Rimondi, Eugenio; Rossi, Giuseppe; Calabrò, Teresa; Ruggieri, Pietro

doi:10.3928/01477447-20130523-02

Cited by 4 publications

(4 citation statements)

References 5 publications

(17 reference statements)

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“…CT-guided procedures allow the accurate placement of needles in three planes for biopsies, even of the smallest visible lesions (Fig. 8) [19]. It also guides probes for tumoral ablation with ultrasound radiofrequency, microwave, chemical, or cryo-ablation [20].…”

Section: Resultsmentioning

confidence: 99%

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Bone Tumor Imaging, Then and Now

Mintz

Hwang

2014

HSS Jrnl

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Background: Musculoskeletal tumor imaging is a focused subspecialty of musculoskeletal radiology. The goals of imaging and techniques employed are continually evolving and often slightly different from those used in other musculoskeletal diseases. As these techniques change, it is occasionally useful to review what is new. Questions/Purposes: The question addressed in this manuscript is what are the most interesting/relevant changes in each modality of musculoskeletal tumor imaging over the past 38 years, the length of time the newly emeritus chair of the Radiology and Imaging Department of Hospital for Special Surgery has been at the hospital. Methods: This review is primarily expert opinion based in examining techniques used at the institutions of the authors, with support from current literature. Results: The techniques of computed tomography (CT) and magnetic resonance imaging (MRI) are new to the imaging armamentarium, and ultrasound and nuclear medicine techniques have advanced considerably with technology. Although radiographs have also evolved, the changes are less apparent, except in how they are currently processed, viewed, and stored. Conclusions: Radiographic evaluation is still critical to evaluating bone tumors. Newer techniques also play an important role in diagnosing and treating these neoplasms.

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Section: Resultsmentioning

confidence: 99%

“…8) [19]. It also guides probes for tumoral ablation with ultrasound radiofrequency, microwave, chemical, or cryo-ablation [20].…”

Section: Computed Tomographymentioning

confidence: 99%

Bone Tumor Imaging, Then and Now

Mintz

Hwang

2014

HSS Jrnl

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“…Common Local Anesthetics.-Most soft-tissue lesions are amenable to biopsy with the use of local anesthetics alone. Biopsy may also be performed with local anesthesia for bone lesions with a large soft-tissue component or erosion of the overlying cortex with local anesthesia (56,57). In our experience, biopsy of bone lesions with large extraosseous soft-tissue components is typically pain free after appropriate numbing of the soft tissues with a local anesthetic.…”

Section: Local Anesthetics and Moderate Sedationmentioning

confidence: 95%

Pearls and Pitfalls for Soft-Tissue and Bone Biopsies: A Cross-Institutional Review

et al. 2020

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Management of soft-tissue and bone neoplasms depends on a definitive histologic diagnosis. Percutaneous image-guided biopsy of bone and soft-tissue tumors is a cost-effective and accurate method to obtain a histopathologic diagnosis. Biopsy requests must be approached thoughtfully to avoid numerous potential pitfalls. Hasty biopsy planning places the patient at increased risk for misdiagnosis, delayed therapy, repeated invasive procedures, and substantial morbidity. Biopsy planning begins with a thorough review of the relevant clinical history and pertinent imaging. The biopsy route must be planned in concert with the referring orthopedic oncologist to preserve limb-sparing options. Carefully selecting the most appropriate imaging modality to guide the biopsy increases the chances of reaching a definitive diagnosis. It is also critical to identify and target with expertise the part of the lesion that is most likely to yield an accurate diagnosis. Percutaneous biopsy is a safe procedure, and familiarity with preprocedural laboratory testing parameters, anticoagulation guidelines, and commonly used sedation medications minimizes the risk of complications while ensuring patient comfort. Nondiagnostic biopsy results are not infrequent and may still have value in guiding patient treatment. Awareness of the imaging manifestations of tumor recurrence is also important. The aim of this article is to provide a comprehensive review of pertinent preprocedural, periprocedural, and postprocedural considerations for bone and soft-tissue musculoskeletal biopsies.

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“…Image-guided tissue harvesting is a well-established minimally invasive procedure that has been primarily used for the diagnosis of bone and soft-tissue abnormalities 15,16 . This method currently is performed with use of computed tomography (CT), ultrasound, and magnetic resonance imaging (MRI) in the outpatient setting, and it is feasible and comparable with open biopsy in terms of costs, complications, and patient satisfaction 17,18 .…”

mentioning

confidence: 99%

Image-Guided Chondrocyte Harvesting for Autologous Chondrocyte Implantation

Zikria

Hafezi-Nejad

Patten

et al. 2019

JBJS OA

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Background: Autologous chondrocyte implantation (ACI), a promising modality for repairing full-thickness cartilage defects, requires 2 consecutive arthroscopic procedures for chondrocyte harvesting and implantation. In the present study, we assessed the feasibility and efficacy of image-guided chondrocyte harvesting as an alternative to arthroscopic biopsy. Methods: We induced full-thickness cartilage defects in 10 human cadaveric knees. Computed tomographic arthrography (CTA) was performed following the intra-articular administration of Omnipaque 350 to measure the diameters of the induced cartilage defects. Subsequently, 2 independent operators conducted CTA-guided chondrocyte harvesting (from the medial and lateral trochlear ridges) in each knee. The time for chondrocyte harvesting, accuracy (distance between the predefined target on CTA and the final insertion site of the needle), and number of needle readjustments were recorded. In the institutional review board-approved clinical study, informed consent was obtained and chondrocyte harvesting was performed both with use of a conventional arthroscopic biopsy method and with use of a needle through an arthroscopy access site in 10 subjects for whom ACI was indicated. The samples were processed and cultured blindly, and the quantity and quality of the samples were determined. Results: CTA measurements of full-thickness cartilage defects showed high to perfect absolute agreement and consistency when compared with direct measurements (overall interclass correlation coefficient, 0.933 to 0.983; p < 0.05). For both operators, image-guided chondrocyte harvesting from the lateral ridge was more accurate (p = 0.007 and 0.040) and faster (p = 0.056 and 0.014) in comparison with harvesting from the medial ridge. In the clinical study, no significant difference was observed for the growth index of samples between the needle-harvest and conventional methods (p = 0.897). Conclusions: CTA can be used for precise measurement of full-thickness cartilage defects. Image-guided chondrocyte harvesting is a viable alternative to traditional arthroscopic biopsy for ACI. Clinical Relevance: We recognize the current pivotal role of arthroscopic biopsy, as a part of ACI, for chondrocyte harvesting as well as for delineating the nature of the lesion. However, on the basis of our results, image-guided chondrocyte retrieval may obviate the need for arthroscopic biopsy in some patients in the future.

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CT-guided Biopsy for Musculoskeletal Lesions

Cited by 4 publications

References 5 publications

Bone Tumor Imaging, Then and Now

Bone Tumor Imaging, Then and Now

Pearls and Pitfalls for Soft-Tissue and Bone Biopsies: A Cross-Institutional Review

Image-Guided Chondrocyte Harvesting for Autologous Chondrocyte Implantation

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