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

Meek, Ryan D.; Mills, Megan; Hanrahan, Christopher J.; Beckett, Brooke; Leake, Richard; Allen, Hailey; Williams, Don D.; Tommack, Matthew; Schmahmann, Sandra; Hansford, Barry G.

doi:10.1148/rg.2020190089.pres

Cited by 6 publications

(25 citation statements)

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“…6c) maximizing the benefits of the procedure by ensuring full coverage of the tumor while minimizing complications to surrounding vital structures. 65,80 Advantages of Cryoablation 1. Better visualization and control of the region ablated and direct visualization of the cryoablation zone (ice ball) both on CT and MRI, allowing for better planning while avoiding surrounding nontarget structures, particularly nerves.…”

Section: Cryoablation Techniquementioning

confidence: 99%

Interventional Techniques for Bone and Musculoskeletal Soft Tissue Tumors: Current Practices and Future Directions - Part I. Ablation

Dalili

Isaac

Bazzocchi

et al. 2020

Semin Musculoskelet Radiol

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Musculoskeletal (MSK) image-guided oncologic intervention is an established field within radiology. Numerous studies have described its clinical benefits, safety, cost effectiveness, patient satisfaction, and improved quality of life, thereby establishing image-guided oncologic intervention as a preferred pathway in treating patients presenting with specific benign MSK tumors. But there is a paradigm shift on the horizon because these techniques may also support established pillars (surgery, systemic treatment, radiotherapy) in the treatment of malignant MSK tumors. Unlike benign tumors, where they are used as primary therapy lines with curative intent, such interventions can be selected for malignant tumors as adjuvant treatment in painful or unstable bone or soft tissue lesions or as more palliative therapy strategies. Using examples from our clinical practices, we elaborate on the benefits of applying a multidisciplinary approach (traditionally involving MSK radiologists, oncologists, orthopaedic surgeons, microbiologists, pathologists, physiotherapists, and pain management experts), ideally within a sarcoma treatment center to deliver a patient-specific therapy plan and illustrate methods to assess the benefits of this model of care.In this article, we review the current repertoire of ablation techniques, demonstrate why such procedures offer value-based alternatives to conventional treatments of specific tumors, and reflect on future directions. Additionally, we review the advantages and limitations of each technique and offer guidance to improve outcomes.

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Section: Cryoablation Techniquementioning

confidence: 99%

Interventional Techniques for Bone and Musculoskeletal Soft Tissue Tumors: Current Practices and Future Directions - Part I. Ablation

Dalili

Isaac

Bazzocchi

et al. 2020

Semin Musculoskelet Radiol

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“…An example is a teleangietac osteosarcoma and aneurysmal bone cyst [25]. erefore, in cases where it is impossible to exclude the malignant process, a biopsy is necessary [24]. Also in our study, even though patients in the study group were treated only due to benign bone lesions, a biopsy was performed in 73% of cases.…”

Section: Discussionmentioning

confidence: 64%

“…In the case of benign bone tumors, a biopsy is not always required. Asymptomatic lesions that do not raise suspicion of a malignant process and that grow over a long period, maybe treated without a prior biopsy [24]. However, in some cases, bone sarcomas may imitate benign neoplasms.…”

Section: Discussionmentioning

confidence: 99%

The use of bone substitute (CERAMENT) in the treatment of benign bone tumors and tumor-like lesions

Zrodowski¹,

Ciechanowicz²,

Dembski³

et al. 2022

Chir. Narzadow Ruchu Ortop. Pol.

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Introduction. Treatment of benign bone tumors and tumor-like lesions is undertaken by numerous Orthopedic surgeons worldwide. Several treatment modalities exist including curettage and bone grafting. CERAMENT is a novel bioresorbable bone substitute used for grafting. Aim. Assessment of preliminary result of treatment of benign bone tumors and tumors like lesions utilizing CERAMENT as a bone substitute. Analysis of therapeutic and diagnostic path and symptoms reported by patients with tumors and tumor-like lesions. Materials and methods. To the retrospective study 38 patients undergoing curettage and bone substitution with CERAMENT® BONE VOID FILLER were included (26% of them were females). We utilized patients’ history. Each patient had an X-ray in the twelfth month after surgery, which was analyzed using the modified Neer classification. The follow-up was 24 months. Results. The unicameral bone cyst was the most commonly encountered lesion (36.8%). Pain was the most common symptom reported (28.9%). Half of all cases were discovered accidentally on X-rays ordered for a different indication. Nearly a quarter of the cases (23.7%) were complicated by pathologic fracture. The distribution of scores in modified Neer score was as follow: SCORE I- 52.6% SCORE II- 15.8% SCORE III-10.6% SCORE IV-2.6%. Complications of procedure were noted in 18.4% of patients. 10.5% of patients had serious discharge from the operated site, 7.9% of patients had surgical wound infection. One case of recurrence was noted. Conclusions. Bone substitute – CERAMENT is suitable for use in the treatment of benign bone tumors and tumors like lesions. It is easy in application and is well tolerated by the patients. The problem is the relatively high rate of complications, mainly serous leakage from the wound.

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“…In addition, high-grade myxofibrosarcoma contains myxoid areas which are morphologically identical to pure low-grade lesions [5]. Therefore, sampling of myxoid areas only can lead to under-grading of the tumor [5,31]. While these different tumor components can be identified on MRI-guided biopsies, accurate percutaneous biopsy of myxofibrosarcomas may be a challenge under US guidance.…”

Section: Us-guided Biopsies Of Myxofibrosarcomasmentioning

confidence: 99%

Ultrasound of myxofibrosarcoma

Morag

Lucas

2021

Skeletal Radiol

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The ultrasound appearance of myxofibrosarcoma is highly variable corresponding to its variable and at times heterogeneous histopathologic appearance. Myxofibrosarcomas may mimic a benign process and the infiltrative tumor margins may be difficult to precisely delineate on ultrasound imaging. These tumor characteristics pose a diagnostic challenge on ultrasound evaluation. The radiologist should be aware of the variable morphologic presentation and infiltrative nature of myxofibrosarcoma and the limitations of ultrasound in the initial diagnosis, biopsy guidance, and post-surgical follow-up of this tumor.

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

Cited by 6 publications

References 0 publications

Interventional Techniques for Bone and Musculoskeletal Soft Tissue Tumors: Current Practices and Future Directions - Part I. Ablation

Interventional Techniques for Bone and Musculoskeletal Soft Tissue Tumors: Current Practices and Future Directions - Part I. Ablation

The use of bone substitute (CERAMENT) in the treatment of benign bone tumors and tumor-like lesions

Ultrasound of myxofibrosarcoma

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