Relative Sensitivity of Core-Needle Biopsy and Incisional Biopsy in the Diagnosis of Musculoskeletal Sarcomas

Klein, Alexander; Fell, Theresa; Birkenmaier, Christof; Fromm, Julian; Jansson, Volkmar; Knösel, Thomas; Dürr, Hans‐Roland

doi:10.3390/cancers13061393

Cited by 14 publications

(10 citation statements)

References 40 publications

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“…Moreover, six (54.5%) of the initial no-diagnoses were completed successfully with a second-line biopsy, increasing diagnostic accuracy to 96.2%. These results are consistent with recent research on this subject: in bone and soft tissue tumors, Yang et al achieved a diagnostic accuracy of 89% in 509 cases [11]; Klein et al observed 83.6% in their study [12].…”

Section: Diagnostic Accuracysupporting

confidence: 92%

Percutaneous Core Needle Biopsy Can Efficiently and Safely Diagnose Most Primary Bone Tumors

Crenn

Vezole²,

Bouhamama

et al. 2021

Diagnostics

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A biopsy is a prerequisite for the diagnosis and evaluation of musculoskeletal tumors. It is considered that surgical biopsy provides a more reliable diagnosis because it can obtain more tumor material for pathological analysis. However, it is often associated with a significant complication rate. Imaging-guided percutaneous core needle biopsy (PCNB) is now widely used as an alternative to surgical biopsy; it appears to be minimally invasive, possibly with lower complication rates. This study evaluates the diagnostic yield of the preferred use of PCNB in a referral center, its accuracy, and its complication rate. The data relating to the biopsy and the histological analysis were extracted from the database of a bone tumor reference center where PCNB of bone tumors was discussed as a first-line option. 196 bone tumors were biopsied percutaneously between 2016 and 2020. They were located in the axial skeleton in 21.4% (42) of cases, in the lower limb in 58.7% (115), and in the upper limb in 19.9% (39) cases. We obtained a diagnosis yield of 84.7% and a diagnosis accuracy of 91.7%. The overall complication rate of the percutaneous biopsies observed was 1.0% (n = 2), consisting of two hematomas. PCNB performed in a referral center is a safe, precise procedure, with a very low complication rate, and which avoids the need for first-line open surgical biopsy. The consultation between pathologist, radiologist, and clinician in an expert reference center makes this technique an effective choice as a first-line diagnosis tool.

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Section: Diagnostic Accuracysupporting

confidence: 92%

Percutaneous Core Needle Biopsy Can Efficiently and Safely Diagnose Most Primary Bone Tumors

Crenn

Vezole²,

Bouhamama

et al. 2021

Diagnostics

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“…The number of necessary re-biopsies with 0.6% it is to be highlighted here, since from our point of view these must also be evaluated as a complication. Klein et al showed in their study that the number of necessary rebiopsies was signi cantly higher in the case of CNB compared to IB (50 vs. 5; p = 0.003) (Klein, et al 2021).…”

Section: Discussionmentioning

confidence: 88%

The Diagnostic Accuracy of 332 Incisional Biopsies in Patients with Malignant Tumors in the Musculoskeletal System

Dirks

Ewerbeck

Ballhause

et al. 2022

Preprint

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It is known that specimen collection followed by histopathological workup is the core of evidence-based medical therapy of musculoskeletal tumors. There exist many controversies about how a biopsy should be performed. While some centers recommend minimal invasive biopsy procedures, mostly the core needle biopsy (CNB), others prefer the incisional biopsy. This study aimed to determine the accuracy of incisional biopsy for malignant tumors in the musculoskeletal system. Moreover, advantages and disadvantages to other biopsy methods are discussed. This retrospective, single-center study about 844 incisional biopsies (benign and malignant) analysis the diagnostic accuracy of 332 malignant tumors, concerning the final histopathological result. In addition, surgical complications are analyzed to find the best way to plan and treat patients timely and correct. Secondary endpoints are the patients age, the pure operation time, as well as the type of tumor, and the subsequent therapy. In summary, incisional biopsy corresponded a sensitivity of 100% for malignancy in 844 incisional biopsies and a specificity of 97.6% in 332 malignant tumors, but it features greater operative expense (incision/suture 23.5 min) and the risk of general anesthesia. The method of biopsy should be tailored to the individual patient and the experience of the center performing the procedure.

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“…The VBGM of care creates new incentives and is associated with a transformation of healthcare delivery, to create a novel ecosystem. A prerequisite for such transformation of healthcare delivery, however, is the assessment of absolute patient numbers and respective interventions [ 26 ]. We therefore speculate that such novel ecosystem of care delivery, together with measuring the outcome using RMST, may reduce the rate of unplanned whoops resections.…”

Section: Discussionmentioning

confidence: 99%

Biopsy Ratio of Suspected to Confirmed Sarcoma Diagnosis

Mosku

Heesen

Studer

et al. 2022

Cancers

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The ratio of malignancy in suspicious soft tissue and bone neoplasms (RMST) has not been often addressed in the literature. However, this value is important to understand whether biopsies are performed too often, or not often enough, and may therefore serve as a quality indicator of work-up for a multidisciplinary team (MDT). A prerequisite for the RMST of an MDT is the assessment of absolute real-world data to avoid bias and to allow comparison among other MDTs. Analyzing 950 consecutive biopsies for sarcoma-suspected lesions over a 3.2-year period, 55% sarcomas were confirmed; 28% turned out to be benign mesenchymal tumors, and 17% non-mesenchymal tumors, respectively. Of these, 3.5% were metastases from other solid malignancies, 1.5% hematologic tumors and 13% sarcoma simulators, which most often were degenerative or inflammatory processes. The RMST for biopsied lipomatous lesions was 39%. The ratio of unplanned resections was 10% in this series. Reorganizing sarcoma work-up into integrating practice units (IPU) allows the assessment of real-world data with absolute values over the geography, thereby enabling the definition of quality indicators and addressing cost efficiency aspects of sarcoma care.

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Relative Sensitivity of Core-Needle Biopsy and Incisional Biopsy in the Diagnosis of Musculoskeletal Sarcomas

Cited by 14 publications

References 40 publications

Percutaneous Core Needle Biopsy Can Efficiently and Safely Diagnose Most Primary Bone Tumors

Percutaneous Core Needle Biopsy Can Efficiently and Safely Diagnose Most Primary Bone Tumors

The Diagnostic Accuracy of 332 Incisional Biopsies in Patients with Malignant Tumors in the Musculoskeletal System

Biopsy Ratio of Suspected to Confirmed Sarcoma Diagnosis

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