Technique, Safety, and Yield of Bone Biopsies for Histomorphometry in Children

Mubarak, Walid; Pastor, Catherine M.; Gnannt, Ralph; Parra, Dimitri A.; Amaral, João; Temple, Michael; Sochett, Etienne; Connolly, Bairbre

doi:10.1016/j.jvir.2017.07.003

Cited by 4 publications

(6 citation statements)

References 24 publications

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“…10,11 Specimens obtained from lesions containing radiolucent areas, ill-defined margins, and exhibiting recent growth are associated with increased diagnostic yield. 12 Biopsy of sclerotic lesions, by contrast, are associated with decreased diagnostic accuracy rates and increased false-negative rates. 10,11,13 Decreased rates of successful biopsy have also been reported in lesions without an extraosseous component, suggesting biopsy failure is related to inadequate access or penetration of the lesion.…”

Section: Lesion Characteristicsmentioning

confidence: 99%

“…60% of spondylodiscitis that had negative results after the first biopsy. 12 In general, biopsy of a lesion is not attempted more than 3 or 4 times because the chance of obtaining a diagnostic sample is low. 11…”

Section: Figurementioning

confidence: 99%

“…10,11 Specimens obtained from lesions containing radiolucent areas, ill-defined margins, and exhibiting recent growth are associated with increased diagnostic yield. 12…”

Section: Lesion Characteristicsmentioning

confidence: 99%

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Percutaneous Spine Biopsy: A Review of the Current Literature

Nourbakhsh

Hanson

2021

J Am Acad Orthop Surg

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Spine lesions are often the result of pathologic processes elsewhere in the body; prompt and accurate diagnosis are crucial to optimize treatment. Despite modern advances in imaging modalities, definitive diagnosis ultimately requires biopsy and histologic analysis. Although open surgical biopsy has traditionally been considered the benchmark, percutaneous image-guided needle biopsy of the spine has proven to be a safe and highly effective method in making a diagnosis. Choosing the optimal biopsy approach, instrumentation and modality of image guidance may depend on a number of factors including lesion type, location, and level within the spine. Knowledge of relevant anatomy, indications, contraindications, and potential complications are critical to a successful biopsy procedure.

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Section: Lesion Characteristicsmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

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Percutaneous Spine Biopsy: A Review of the Current Literature

Nourbakhsh

Hanson

2021

J Am Acad Orthop Surg

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“…During local anesthesia a 22-gauge spinal needle can be used to apply local anesthetic all the way to the lesion or to the bone periosteum. General anesthesia should be reserved for specific patient groups (e.g., children), very long and very painful complex cases, or cases demanding excellent respiratory control [ 5 , 6 , 17 ]. Biopsy techniques include co-axial technique or tandem approaches for fine needle aspiration or core needle biopsy sampling [ 6 ].…”

Section: Techniquesmentioning

confidence: 99%

Percutaneous, Imaging-Guided Biopsy of Bone Metastases

2018

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Approximately 70% of cancer patients will eventually develop bone metastases. Spine, due to the abundance of red marrow in the vertebral bodies and the communication of deep thoracic-pelvic veins with valve-less vertebral venous plexuses, is the most common site of osseous metastatic disease. Open biopsies run the risk of destabilizing an already diseased spinal or peripheral skeleton segment. Percutaneous biopsies obviate such issues and provide immediate confirmation of correct needle location in the area of interest. Indications for percutaneous bone biopsy include lesion characterization, optimal treatment and tumor recurrence identification, as well as tumor response and recurrence rate prediction. Predicting recurrence in curative cases could help in treatment stratification, identification, and validation of new targets. The overall accuracy of percutaneous biopsy is 90–95%; higher positive recovery rates govern biopsy of osteolytic lesions. The rate of complications for percutaneous biopsy approaches is <5%. The purpose of this review is to provide information about performing bone biopsy and what to expect from it as well as choosing the appropriate imaging guidance. Additionally, factors governing the appropriate needle trajectory that would likely give the greatest diagnostic yield and choice of the most appropriate biopsy system and type of anesthesia will be addressed.

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“…General anesthesia is usually recommended when patient cooperation is suboptimal (e.g., children) or for patients with high narcotic tolerance levels. 1,12,21,22 Bone biopsy should be performed under strict sterile conditions and on completion of biopsy and removal of the needle, the biopsy site is evaluated with imaging to rule out hemorrhage. Patients are usually kept for evaluation of immediate complications and prior to discharge a full explanation, or more preferably printed advice, about potential complications and appropriate postprocedural care must be provided to the patient.…”

Section: Technical Factorsmentioning

confidence: 99%

Bone and Soft-Tissue Biopsies: What You Need to Know

Filippiadis

Charalampopoulos

Mazioti

et al. 2018

Semin intervent Radiol

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Percutaneous, image-guided musculoskeletal biopsy, due to its minimal invasive nature, when compared with open surgical biopsy, is a safe and effective technique which is widely used in many institutions as the primary method to acquire tissue and bone samples. Indications include histopathologic and molecular assessment of a musculoskeletal lesion, exclusion of malignancy in a bone/vertebral fracture, examination of bone marrow, and infection investigation. Preprocedural workup should include both imaging (for lesion assessment and staging) and laboratory (including coagulation tests and platelet count) studies. In selected cases, antibiotic prophylaxis should be administered before the biopsy. Core needle biopsy of musculoskeletal lesions has a diagnostic accuracy that ranges from 66 to 98% with higher diagnostic yield for lytic, large-size, malignant lesions and when multiple and long specimens are obtained. Reported complication rates range between 0 and 10% and usually do not exceed 5%, with a suggested threshold of 2%. The purpose of this review article is to illustrate the technical aspects, the indications, and the methodology of percutaneous image-guided bone biopsy that will assist the interventional radiologist to perform these minimal invasive techniques.

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Technique, Safety, and Yield of Bone Biopsies for Histomorphometry in Children

Cited by 4 publications

References 24 publications

Percutaneous Spine Biopsy: A Review of the Current Literature

Percutaneous Spine Biopsy: A Review of the Current Literature

Percutaneous, Imaging-Guided Biopsy of Bone Metastases

Bone and Soft-Tissue Biopsies: What You Need to Know

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