The tactics and technique of musculoskeletal biopsy

Exner, G. Ulrich; Kurrer, Michael; Mamisch-Saupe, Nadja; Cannon, Stephen R.

doi:10.1302/2058-5241.2.160065

Cited by 30 publications

(48 citation statements)

References 42 publications

(35 reference statements)

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“…14 Our results comply with previous works by previous literature in the field which recommended that ultrasound is the best procedure with the proven efficacy of MSK lesions as a prime choice rather than CT guided biopsy due to higher cost, ionizing radiation exposure, longer time and other disadvantages, and open biopsy with more complications, higher costs and greater strains in patients. [1][2][3][4][5][6][7][8][9]11,12,15 Ultrasound is simple to handle, and provides multi-dimensional, realtime procedure, is typically faster than any other guiding procedure. Ultrasound has no radiation hazards, and is perfect in soft-tissue or bony lesions with cortical destruction.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound and CT guided biopsy of suspicious musculoskeletal lesions: diagnostic performance and implications for the management

Elmageed

Alwahed

Zytoon

2020

IJRRT

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Purpose: Image-guided musculoskeletal (MSK) biopsy could afford initial and ultimate judgment and lead choices to the best treatment. Nonsurgical intervention grants less complication rate than surgical intervention. It is rapid, harmless and decisive procedure yields accuracy in diagnosis up to 96%. Ultrasound and computed axial tomography represent the key procedures in performing MSK intervention. Numerous needles and procedures are existing for helping the physician accomplishing this procedure without harm. This study was accepted in order to evaluate ultrasound and computed tomography (CT) guided core needle biopsies (CNB) of musculoskeletal lesions accurateness, and medical worth in the management plan. Materials and methods: Fifty patients with MSK lesions underwent image guided (Ultrasound or CT guided) CNB for histopathological diagnosis. Radiological, pathological and clinical data were recorded and analyzed. Results: Of fifty CNBs, forty nine (98 %) were adequate to obtain pathological diagnosis while one CNB (2 %) seemed to be inadequate. Of the fifty CNBs, forty eight patients (96%) were correctly diagnosed while two patients (4%) were misdiagnosed and this gives an overall accuracy rate of 96%. Conclusion: The image guided CNB of MSK lesions signify the decisive and harmless method for gaining a final histopathological decision.

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Section: Discussionmentioning

confidence: 99%

“…General anesthesia is frequently needed for patients who cannot endure motionless and children. 9 Ultrasound is the regular procedure used for accomplishing soft tissue biopsies. Ultrasound extensively exists, negligibly aggressive, real-time and multiplanar modality.…”

Section: Assessment For Cancer Relapsementioning

confidence: 99%

Ultrasound and CT guided biopsy of suspicious musculoskeletal lesions: diagnostic performance and implications for the management

Elmageed

Alwahed

Zytoon

2020

IJRRT

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“…41 Reported complications include bleeding and hematoma, infection, neural injury, bone fracture, needle tip breakage, surrounding organ damage, and needle tract seeding. 1,42 Significant bleeding is rare, 1 fracture risk is higher in very lytic lesions 42 and needle tract seeding may be affected by needle size, number of needle passes, tumor type, and location of the lesion. 21 Careful planning of the biopsy route is very important.…”

Section: Efficacy and Complicationsmentioning

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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“…When a pelvic bone metastasis is favoured, intramuscular needle path is less determinant, albeit cases of tumour seeding along the needle path after core biopsy have been reported [ 25 ]. A direct access through gluteal muscles can be used provided that no major vessels or nerves lie in the needle path.…”

Section: Technical Considerationsmentioning

confidence: 99%

“…A 10- to 16-G bone biopsy needle is indicated for dense lesions and when the cortex is intact. A coaxial technique is recommended because it allows keeping bone access to take several samples and occasionally perform percutaneous embolisation, and also protects the needle path from tumour dissemination [ 24 , 25 ].…”

Section: Technical Considerationsmentioning

confidence: 99%

A practical guide for planning pelvic bone percutaneous interventions (biopsy, tumour ablation and cementoplasty)

Miranda

Moser

2018

Insights Imaging

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Percutaneous approaches for pelvic bone procedures (bone biopsies, tumour ablation and cementoplasty) are multiple and less well systematised than for the spine or extremities. Among the different imaging techniques that can be used for guidance, computed tomography (CT) scan is the modality of choice because of the complex pelvic anatomy. In specific cases, such as cementoplasty where real-time evaluation is a determinant, a combination of CT and fluoroscopy is highly recommended. The objective of this article is to propose a systematic approach for image-guided pelvic bone procedures, as well as to provide some technical tips. We illustrate the article with multiple examples, and diagrams of the approaches and important structures to avoid to perform these procedures safely.Teaching Points• Pelvic bone procedures are safe to perform if anatomical landmarks are recognised.• The safest approach varies depending on the pelvic level.• CT is the modality of choice for guiding pelvic percutaneous procedures.• Fluoroscopy is recommended when real-time monitoring is mandatory.• MRI can also be used for guiding pelvic percutaneous procedures.

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The tactics and technique of musculoskeletal biopsy

Cited by 30 publications

References 42 publications

Ultrasound and CT guided biopsy of suspicious musculoskeletal lesions: diagnostic performance and implications for the management

Ultrasound and CT guided biopsy of suspicious musculoskeletal lesions: diagnostic performance and implications for the management

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

A practical guide for planning pelvic bone percutaneous interventions (biopsy, tumour ablation and cementoplasty)

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