Percutaneous CT-guided biopsy of the musculoskeletal system: Results of 2027 cases

Rimondi, Eugenio; Rossi, Giuseppe; Bartalena, Tommaso; Ciminari, Rosanna; Alberghini, Marco; Ruggieri, Pietro; Errani, Costantino; Angelini, Andrea; Calabrò, Teresa; Abati, Caterina Novella; Balladelli, Alba; Tranfaglia, Cristina; Mavrogenis, Andreas F.; Vanel, D.; Mercuri, Mario

doi:10.1016/j.ejrad.2010.06.055

Cited by 130 publications

(139 citation statements)

References 14 publications

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“…More recent studies report that complication rates are negligible, as they are very low. For instance, Rimondi et al described 22 complications in 2027 CT-guided biopsies, which represents a complication rate of 1.1 % [25]. For comparison in open biopsy the complication rate may be as high as 16 % [26].…”

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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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mentioning

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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“…First, only open biopsies were included because this is the preferred procedure to obtain diagnostic tissue at the study institution for most benign aggressive and malignant bone tumors and high-grade soft tissue sarcomas. Although we recognize core needle biopsies are perfectly reasonable to reach a diagnosis, incisional biopsy provides pretreatment material in sufficient quantity to support translational research initiatives and is sometimes necessary when a core biopsy is nondiagnostic [20]. Excluding patients who underwent needle/core biopsies restricts the applicability of the findings to patients who undergo incisional biopsies.…”

Section: Discussionmentioning

confidence: 99%

“…Although a definitive diagnosis will not always be reached with a biopsy, it is expected that enough information will be added to the clinical and radiological data so that appropriate care can be provided. Despite the availability of percutaneous core biopsies, incisional biopsies provide unaltered pretreatment tissue specimens for research purposes and are sometimes necessary when a core or needle biopsy fails to provide a definitive diagnosis [20].…”

Section: Introductionmentioning

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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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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“…However, because of the increased risks of infection, wound healing problems, hematoma formation, pathological fractures, and tumor contamination of healthy tissues, open biopsy should be performed only if a previously attempted percutaneous biopsy has been nondiagnostic. [1][2][3] In addition, excisional biopsy should be performed only for superficial, small (3 cm or less) lesions that can be excised with clear margins. 3 Moreover, in spinal and deep-seated pelvic lesions, an open biopsy can be a difficult procedure and has a significant risk of tumor spread and tissue contamination.…”

Section: How To Perform a Biopsymentioning

confidence: 99%

“…1,3 Biopsy is used to determine the nature of a solitary musculoskeletal lesion with nonspecific imaging features, to confirm or exclude musculoskeletal metastasis in patients with a known primary malignant tumor, to confirm or exclude malignancy (most commonly metastases or myeloma) in patients with vertebral body compression fractures, to evaluate local recurrences after surgical or medical treatment,to examine the etiology of pathological fractures, and to identify musculoskeletal infections. Absolute contraindications for a musculoskeletal biopsy are coagulopathy and hydatidosis and instances when biopsy is not expected to give additional information or does not change patients' management.…”

Section: When To Perform a Biopsymentioning

confidence: 99%

CT-guided Biopsy for Musculoskeletal Lesions

Mavrogenis¹,

Rimondi²,

Rossi³

et al. 2013

Orthopedics

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Percutaneous CT-guided biopsy of the musculoskeletal system: Results of 2027 cases

Cited by 130 publications

References 14 publications

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

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

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

CT-guided Biopsy for Musculoskeletal Lesions

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