Optimized CT Attenuation and SUV Prediction Thresholds for Differentiating Enostoses From Untreated and Treated Metastases on Attenuation-Corrected 18F-FDG PET/CT

Lee, Harrison T.; Pryma, Daniel A.; Sebro, Ronnie

doi:10.1097/rlu.0000000000002808

Cited by 5 publications

(2 citation statements)

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“…1). While the mean CT attenuation has been shown to be useful for differentiating bone islands from metastases and for predicting the likelihood of FNA yield for bone biopsies, we found that it was less informative for predicting positive bone cultures.…”

Section: Discussioncontrasting

confidence: 56%

Predictors of positive bone cultures from CT‐guided bone biopsies performed for suspected osteomyelitis

Lee

Sebro

2020

J Med Imag Rad Onc

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Introduction Bone biopsies are often used to direct antibiotic choice in patients with suspected osteomyelitis. The aim of this study was to identify the best predictors of positive bone biopsy cultures. Methods A retrospective review of 845 patients who underwent computed tomography (CT)‐guided non‐spine bone biopsies at a tertiary academic healthcare institution. Thirty‐seven patients (4.4%) had biopsies performed for suspected osteomyelitis. Laboratory markers, as well as imaging features, were measured. t‐Tests and Fisher’s exact tests were used to compare clinical and demographic variables between patients with positive bone cultures and patients with negative bone cultures. Multivariable logistic regression was used to identify the best predictors of bone culture positivity. Results All patients had negative blood cultures; however, only eight patients (21.6%) had positive bone cultures, with Staphyloccocus the most common organism. Multivariable logistic regression analysis showed that an open wound (OR = 14.00, 95% CI (1.74, 112.4), p = 0.013) and any fluid aspirated at the time of biopsy (OR = 10.50, 95% CI (1.21, 91.01), p = 0.033) were the best predictors of bone culture positivity. The area under the curve (AUC) for this multivariable model was 0.784 with sensitivity and specificity of 0.778 and 0.778, respectively. Interestingly, and contrary to popular belief, open wounds with exposed bone did not always yield positive bone cultures, and when cultures were positive, were not polymicrobial. Conclusions Aspiration of fluid at the time of biopsy and the presence of an open wound are the best predictors of positive bone cultures.

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Section: Discussioncontrasting

confidence: 56%

Predictors of positive bone cultures from CT‐guided bone biopsies performed for suspected osteomyelitis

Lee

Sebro

2020

J Med Imag Rad Onc

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“… 13 CT studies used for staging/surveillance also cannot differentiate a treated lesion from a viable untreated lesion. 14 Because treatment history may often be unknown, there is a need for an imaging test that can be used to help predict whether a diagnostic bone biopsy will be show malignancy.…”

Section: Introductionmentioning

confidence: 99%

Utility of absolute apparent diffusion coefficient and chemical‐shift imaging versus CT attenuation for predicting malignancy from percutaneous bone biopsies

Sebro

Ashok

2021

J of Medical Radiation Sci

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Introduction: Bone lesions are sometimes detected on computed tomography studies, and biopsies are performed to evaluate whether these are malignant. The aim of the study is to evaluate whether chemical-shift imaging (CSI) and diffusion-weighted imaging (DWI) magnetic resonance imaging (MRI) are more informative than the CT attenuation for predicting malignancy. Methods: Retrospective analysis of 86 patients who underwent both diagnostic CT, CSI MRI and DWI MRI within 6 weeks prior to bone biopsy at a tertiary care academic institution between 01/01/2010 and 03/01/2020. The CT attenuation, signal intensity on in-phase sequences (SIIP), signal intensity on out-of-phase sequences (SIOP), signal intensity ratio (SIR = SIOP/SIIP) and the apparent diffusion coefficient (ADC) of the lesions over the region of the biopsy tract were measured. Results: A threshold CT attenuation of 157 Hounsfield Units (HU) had a sensitivity of 47.7%, specificity of 83.3% and area under the curve (AUC) of 0.59. A threshold ADC of 793 9 10 À6 mm 2 /s had a sensitivity of 75.8%, specificity of 85.7% and AUC of 0.83 to predict whether a bone biopsy would detect malignancy. A threshold SIR of 0.949 had a sensitivity of 77.8%, specificity of 77.8% and AUC of 0.81 to predict whether a bone biopsy would detect malignancy. ADC (P = 0.029) and SIR (P = 0.009) were significantly better than CT attenuation. There was no predictive difference between SIR and ADC (P = 0.742). Conclusions: The CT attenuation of a lesion is a poor predictor of malignancy in bone lesions. CSI and DWI are significantly better for predicting malignancy.

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Osteoid Tumors of Bone

Amini

Valenzuela

Bird

et al. 2021

Seminars in Ultrasound, CT and MRI

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Optimized CT Attenuation and SUV Prediction Thresholds for Differentiating Enostoses From Untreated and Treated Metastases on Attenuation-Corrected 18F-FDG PET/CT

Cited by 5 publications

References 10 publications

Predictors of positive bone cultures from CT‐guided bone biopsies performed for suspected osteomyelitis

Predictors of positive bone cultures from CT‐guided bone biopsies performed for suspected osteomyelitis

Utility of absolute apparent diffusion coefficient and chemical‐shift imaging versus CT attenuation for predicting malignancy from percutaneous bone biopsies

Osteoid Tumors of Bone

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