Percutaneous Spine Biopsy: A Review of the Current Literature

Nourbakhsh, Ali; Hanson, Zachary C.

doi:10.5435/jaaos-d-20-00100

Cited by 5 publications

(4 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In clinical practice, imaging-guided spinal biopsies are crucial for the diagnosis and management of spinal infections and malignancies. However, nondiagnostic or inadequate specimen samples are obtained in approximately 8% to 10% of biopsies with adequate preparation and standard operating procedures 7. Several systematic reviews4–6 reported a diagnostic accuracy of 33% to 48% in CT-guided needle biopsy among patients with spinal infections.…”

Section: Discussionmentioning

confidence: 99%

“…However, nondiagnostic or inadequate specimen samples are obtained in approximately 8% to 10% of biopsies with adequate preparation and standard operating procedures. 7 Several systematic reviews [4][5][6] reported a diagnostic accuracy of 33% to 48% in CT-guided needle biopsy among patients with spinal infections. Therefore, it is necessary to identify imaging findings that can improve the diagnostic accuracy of biopsy in spinal lesions.…”

Section: Discussionmentioning

confidence: 99%

“…However, the first biopsy was reported to provide a specific diagnosis in 33% to 48% of cases of spinal infections,4–6 and a second biopsy is usually difficult to perform in patients who have nondiagnostic results after the first procedure. In addition, 40% of spondylodiscitis cases may be missed by standard biopsy 7. Therefore, it is necessary to identify imaging findings that can improve diagnostic accuracy, especially in patients with nonspecific clinical manifestations.…”

mentioning

confidence: 99%

“…In addition, 40% of spondylodiscitis cases may be missed by standard biopsy. 7 Therefore, it is necessary to identify imaging findings that can improve diagnostic accuracy, especially in patients with nonspecific clinical manifestations.…”

mentioning

confidence: 99%

See 3 more Smart Citations

A Combined Scoring Method Based on 18F-FDG PET/CT for Distinguishing Spinal Infection From Malignancy

Chen

et al. 2022

Spine

View full text Add to dashboard Cite

Study Design. Retrospective study. Objective. This study aimed to explore the additional value of fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for the detection of early-stage and atypical spinal infections and to find the best combination of indicators from laboratory and imaging systems for higher diagnostic efficiency. Summary of Background Data. Diagnosis of early-stage and atypical spinal infections may be challenging for clinicians. It is particularly important to distinguish spinal infection from malignancy to develop a timely treatment strategy and avoid unnecessary biopsy or surgery. Materials and Methods. All patients with a discharge diagnosis of spinal infection or malignancy who underwent 18F-FDG PET/CT scans before spinal biopsy between January 1, 2014, and July 30, 2021, were included. Laboratory and imaging data were assessed. A receiver operating characteristic (ROC) curve was created, and the best cut-off point and cumulated area under the curve (AUC) were obtained to distinguish between spinal infection and malignancy. Kappa values were used to assess the agreement between the 18F-FDG PET/CT and MRI findings. Binary logistic regression was used to screen for statistically significant indicators and imaging findings. Results. A total of 71 patients with confirmed spinal infections (n=30) or malignancies (n=41) were included in this study. Elevated ESR and significantly elevated tumor biomarkers or positive FLCs assay were significantly different between the two groups. In addition to the total lesion glycolysis of the involved vertebral bodies derived from 18F-FDG PET/CT, four imaging findings (consecutive multilevel vertebral lesions, intervertebral disc, vertebral arch, and extraspinal involvement) also showed significant differences between the two groups (P≤0.010). A combined scoring method based on the above seven indicators was designed with an overall classification accuracy of 95.2%, and it identified all patients with spinal infections (100%, 28/28). In addition, moderate-to-excellent agreement could be reached for the involvement of intervertebral discs, paravertebral soft tissues, and vertebral arches derived from MRI and18F-FDG PET/CT. Conclusions. The combined scoring method based on 18F-FDG PET/CT provided excellent overall accuracy in distinguishing spinal infections from malignancies. This approach may prove useful for patients with MRI contraindications or with equivocal results following laboratory tests or traditional imaging when there is high suspicion for spinal infections or malignancy.

show abstract

Section: Discussionmentioning

confidence: 99%