Görüntüleme Eşliğinde Yapılan Kemik Biyopsilerinde Tanı Yeterliliğini Etkileyen Faktörler: Retrospektif Bir Analiz Çalışması
Abstract
Amaç: Kemik lezyonları için görüntüleme eşliğinde yapılan perkütan kor iğne biyopsisinin tanı yeterliliğini etkileyen faktörleri değerlendirmek.
Yöntem: Haziran 2020 ile Haziran 2024 arasında kemik lezyonları için 226 görüntüleme eşliğinde perkütan kor iğne biyopsisi uygulanan 211 hasta retrospektif olarak değerlendirildi. Hasta yaşı, lezyon lokalizasyonu, biyopsi rehberliğinde kullanılan modalite (ultrason vs. BT) ve biyopsi öncesi görüntüleme yöntemleri (PET/CT, MRI) gibi çeşitli değişkenlerin biyopsi yeterliliği üzerindeki etkisi araştırıldı.
Bulgular: Olguların %70,1'inde (148/211) biyopsi sonucu tanısal açıdan yeterli bulundu. Daha ileri yaş grubunda tanısal yeterlilik oranı anlamlı olarak daha yüksek saptandı (p=0,001). Üst ekstremite ve aksiyal iskelet yerleşimli lezyonlarda tanısal yeterlilik daha yüksek bulundu. US rehberliğinde biyopsi yapılan olgularda, BT rehberliğine göre daha yüksek oranda yeterlilik sağlandı (p<0,001). Ayrıca, biyopsi öncesi MRI kullanımı yetersiz tanı gruplarında daha yüksekken (p=0,005), biyopsi öncesi PET/CT kullanımı daha düşük bulundu (p=0,034). Biyopsi öncesi PET/CT yapılan hastalarda, yeterli tanı sağlananların SUV değerlerinin, yetersiz tanı sağlananlara göre anlamlı derecede yüksek olduğu görüldü (p=0,004).
Sonuç: Çalışma, kemik biyopsilerinde tanı yeterliliğini etkileyen faktörleri ortaya koymakta ve klinik karar verme sürecinde yol gösterici olabilecek önemli bilgiler sunmaktadır. Bu faktörlerin anlaşılması, tanı yeterliliğini artırarak kemik lezyonları olan hastaların tedavi planlamasına katkıda bulunabilir.
Keywords
Kemik neoplazmları görüntüleme eşliğinde biyopsi bilgisayarlı tomografi ultrasonografi iğne biyopsisi
Ethical Statement
Makale için etik kurul onayı alınmış olup yazarlar arasında çıkar çatışması yoktur.
References
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- 7. Sung KS, Seo SW, Shon MS. The diagnostic value of needle biopsy for musculoskeletal lesions. Int Orthop. 2009;33(6):1701-1706.
- 8. Yang J, Frassica FJ, Fayad L, Clark DP, Weber KL. Analysis of nondiagnostic results after image-guided needle biopsies of musculoskeletal lesions. Clin Orthop Relat Res. 2010;468(11):3103-3111.
- 9. Hwang S, Lefkowitz RA, Landa J, et al. Percutaneous CT-guided bone biopsy: Diagnosis of malignancy in lesions with initially indeterminate biopsy results and CT features associated with diagnostic or indeterminate results. AJR Am J Roentgenol. 2011;197(6):1417-1425.
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- 11. Jelinek JS, Murphey MD, Welker JA, et al. Diagnosis of primary bone tumors with image-guided percutaneous biopsy: Experience with 110 tumors. Radiology. 2002;223(3):731-737.
- 12. Gul SB, Polat AV, Bekci T, Selcuk MB. Accuracy of percutaneous ct-guided spine biopsy and determinants of biopsy success. J Belg Soc Radiol. 2016;100(1):62.
- 13. Kim W, Sun K, Kung JW, Wu JS. CT-guided core needle biopsy of nonspinal bone lesions: Comparison of occult and visible bone lesions. AJR Am J Roentgenol. 2023;220(1):104-114. doi: 10.2214/AJR.22.27842.
- 14. Nouh MR, Abu Shady HM. Initial CT-guided needle biopsy of extremity skeletal lesions: Diagnostic performance and experience of a tertiary musculoskeletal center. Eur J Radiol. 2014;83(2):360-365. doi: 10.1016/j.ejrad.2013.10.012.
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- 21. Crenn V, Vezole L, Bouhamama A, et al. Percutaneous core needle biopsy can efficiently and safely diagnose most primary bone tumors. Diagnostics (Basel). 2021;11(9):1552. doi: 10.3390/diagnostics11091552.
- 22. Lee SA, Chiu CK, Chan CYW, et al. The clinical utility of fluoroscopic versus CT-guided percutaneous transpedicular core needle biopsy for spinal infections and tumors: A randomized trial. Spine J. 2020;20(7):1114-1124. doi: 10.1016/j.spinee.2020.03.015.
- 23. Boriani S, Ruggieri P, Sudanese A. Biopsy: Considerations on surgical technique derived from a study of 749 cases of bone tumors. Ital J Orthop Traumatol. 1984;10(4):489-499.
- 24. Skrzynski MC, Biermann JS, Montag A, Simon MA. Diagnostic accuracy and charge-savings of outpatient core needle biopsy compared with open biopsy of musculoskeletal tumors. J Bone Joint Surg Am. 1996;78(5):644-649. doi: 10.2106/00004623-199605000-00002.
- 25. Alanen J, Keski-Nisula L, Blanco-Sequeiros R, Tervonen O. Cost comparison analysis of low-field (0.23 T) MRI- and CT-guided bone biopsies. Eur Radiol. 2004;14(1):123-128. doi: 10.1007/s00330-003-1960-2.
- 26. Ponti F, Arioli A, Longo C, et al. Ultrasound-guided percutaneous bone biopsy: Feasibility, diagnostic yield and technical notes. Diagnostics (Basel). 2023;13(10):1773. doi: 10.3390/diagnostics13101773.
- 27. Spinnato P, Colangeli M, Rinaldi R, Ponti F. Percutaneous CT-guided bone biopsies: Indications, feasibility and diagnostic yield in the different skeletal sites-from the skull to the toe. Diagnostics (Basel). 2023;13(14):2350. doi: 10.3390/diagnostics13142350.
- 28. Masood S, Mallinson PI, Sheikh A, Ouellette H, Munk PL. Percutaneous bone biopsy. Tech Vasc Interv Radiol. 2022;25(1):100800. doi: 10.1016/j.tvir.2022.100800.
Predictive Factors Influencing Diagnostic Yield in Image-Guided Bone Biopsies: A Retrospective Analysis
Abstract
Aim: To evaluate the factors that influence the diagnostic yield of image-guided percutaneous core needle biopsy (CNB) for bone lesions.
Method: A retrospective analysis was conducted on 211 patients who underwent 226 image-guided percutaneous core needle biopsies for bone lesions between June 2020 and June 2024. The variables evaluated included patient age, lesion location, the modality used for biopsy guidance (ultrasound vs. CT), and pre-biopsy imaging techniques (PET/CT, MRI).
Results: Diagnostic adequacy was achieved in 70.1% of cases. Key findings revealed that patients with adequate diagnostic yield were significantly older than those with inadequate yield (p=0.001). Lesions located in the lower extremity were more frequently associated with inadequate diagnostic yield (p=0.029), and the use of CT guidance was more common in this group (p<0.001). Additionally, pre-biopsy MRI use was higher in the inadequate yield group (p=0.005), while pre-biopsy PET scan use was lower (p=0.034). Among patients who underwent pre-biopsy PET scans, those with adequate diagnostic yield had significantly higher SUV values compared to those with inadequate yield (p=0.004)
Conclusion: This study highlights key factors influencing diagnostic yield in bone biopsies, providing insights that can guide clinical decision-making. Understanding these factors may help improve diagnostic yield, aiding in appropriate treatment planning for patients with bone lesions.
References
- 1. Li Y, Du Y, Luo TY, et al. Factors influencing diagnostic yield of CT-guided percutaneous core needle biopsy for bone lesions. Clin Radiol. 2014;69(1):e43-e47. doi: 10.1016/j.crad.2013.09.003.
- 2. Didolkar MM, Anderson ME, Hochman MG, et al. Image guided core needle biopsy of musculoskeletal lesions: Are nondiagnostic results clinically useful? Clin Orthop Relat Res. 2013;471(11):3601-3609. doi: 10.1007/s11999-013-3170-9.
- 3. Lis E, Bilsky MH, Pisinski L, et al. Percutaneous CT-guided biopsy of osseous lesions of the spine in patients with known or suspected malignancy. AJNR Am J Neuroradiol. 2004;25(9):1583-15.
- 4. Omura MC, Motamedi K, UyBico S, Nelson SD, Seeger LL. Revisiting CT-guided percutaneous core needle biopsy of musculoskeletal lesions: Contributors to biopsy success. AJR Am J Roentgenol. 2011;197(2):457-461.
- 5. Rimondi E, Rossi G, Bartalena T, et al. Percutaneous CT-guided biopsy of the musculoskeletal system: Results of 2027 cases. Eur J Radiol. 2011;77(1):34-42.
- 6. Saifuddin A, Mitchell R, Burnett SJ, Sandison A, Pringle JA. Ultrasound-guided needle biopsy of primary bone tumors. J Bone Joint Surg Br. 2000;82(1):50-54.
- 7. Sung KS, Seo SW, Shon MS. The diagnostic value of needle biopsy for musculoskeletal lesions. Int Orthop. 2009;33(6):1701-1706.
- 8. Yang J, Frassica FJ, Fayad L, Clark DP, Weber KL. Analysis of nondiagnostic results after image-guided needle biopsies of musculoskeletal lesions. Clin Orthop Relat Res. 2010;468(11):3103-3111.
- 9. Hwang S, Lefkowitz RA, Landa J, et al. Percutaneous CT-guided bone biopsy: Diagnosis of malignancy in lesions with initially indeterminate biopsy results and CT features associated with diagnostic or indeterminate results. AJR Am J Roentgenol. 2011;197(6):1417-1425.
- 10. Issakov J, Flusser G, Kollender Y, Merimsky O, Lifschitz-Mercer B, Meller I. Computed tomography-guided core needle biopsy for bone and soft tissue tumors. Isr Med Assoc J. 2003;5(1):28-30.
- 11. Jelinek JS, Murphey MD, Welker JA, et al. Diagnosis of primary bone tumors with image-guided percutaneous biopsy: Experience with 110 tumors. Radiology. 2002;223(3):731-737.
- 12. Gul SB, Polat AV, Bekci T, Selcuk MB. Accuracy of percutaneous ct-guided spine biopsy and determinants of biopsy success. J Belg Soc Radiol. 2016;100(1):62.
- 13. Kim W, Sun K, Kung JW, Wu JS. CT-guided core needle biopsy of nonspinal bone lesions: Comparison of occult and visible bone lesions. AJR Am J Roentgenol. 2023;220(1):104-114. doi: 10.2214/AJR.22.27842.
- 14. Nouh MR, Abu Shady HM. Initial CT-guided needle biopsy of extremity skeletal lesions: Diagnostic performance and experience of a tertiary musculoskeletal center. Eur J Radiol. 2014;83(2):360-365. doi: 10.1016/j.ejrad.2013.10.012.
- 15. Florkow MC, Willemsen K, Mascarenhas VV, Oei EHG, van Stralen M, Seevinck PR. Magnetic resonance imaging versus computed tomography for three-dimensional bone imaging of musculoskeletal pathologies: A review. J Magn Reson Imaging. 2022;56(1):11-34. doi: 10.1002/jmri.28067.
- 16. Abd Elmageed MK, Abd Alwahed MS, Zytoon AA. Ultrasound and CT guided biopsy of suspicious musculoskeletal lesions: Diagnostic performance and implications for management. Radiodiagnosis. 2020;7(1):1-10.
- 17. Wu JS, Goldsmith JD, Horwich PJ, Shetty SK, Hochman MG. Bone and soft-tissue lesions: What factors affect diagnostic yield of image-guided core-needle biopsy? Radiology. 2008;248(3):962-970. doi: 10.1148/radiol.2483071742.
- 18. Ní Mhuircheartaigh J, McMahon C, Lin YC, Wu J. Diagnostic yield of percutaneous biopsy for sclerotic bone lesions: Influence of mean Hounsfield units. Clin Imaging. 2017;46:53-56. doi: 10.1016/j.clinimag.2017.06.008.
- 19. Toki S, Sone M, Yoshida A, et al. Image-guided core needle biopsy for musculoskeletal lesions. J Orthop Sci. 2022;27(2):448-455. doi: 10.1016/j.jos.2020.12.017.
- 20. Puri A, Shingade VU, Agarwal MG, et al. CT-guided percutaneous core needle biopsy in deep seated musculoskeletal lesions: A prospective study of 128 cases. Skeletal Radiol. 2006;35(3):138-143. doi: 10.1007/s00256-005-0038-4.
- 21. Crenn V, Vezole L, Bouhamama A, et al. Percutaneous core needle biopsy can efficiently and safely diagnose most primary bone tumors. Diagnostics (Basel). 2021;11(9):1552. doi: 10.3390/diagnostics11091552.
- 22. Lee SA, Chiu CK, Chan CYW, et al. The clinical utility of fluoroscopic versus CT-guided percutaneous transpedicular core needle biopsy for spinal infections and tumors: A randomized trial. Spine J. 2020;20(7):1114-1124. doi: 10.1016/j.spinee.2020.03.015.
- 23. Boriani S, Ruggieri P, Sudanese A. Biopsy: Considerations on surgical technique derived from a study of 749 cases of bone tumors. Ital J Orthop Traumatol. 1984;10(4):489-499.
- 24. Skrzynski MC, Biermann JS, Montag A, Simon MA. Diagnostic accuracy and charge-savings of outpatient core needle biopsy compared with open biopsy of musculoskeletal tumors. J Bone Joint Surg Am. 1996;78(5):644-649. doi: 10.2106/00004623-199605000-00002.
- 25. Alanen J, Keski-Nisula L, Blanco-Sequeiros R, Tervonen O. Cost comparison analysis of low-field (0.23 T) MRI- and CT-guided bone biopsies. Eur Radiol. 2004;14(1):123-128. doi: 10.1007/s00330-003-1960-2.
- 26. Ponti F, Arioli A, Longo C, et al. Ultrasound-guided percutaneous bone biopsy: Feasibility, diagnostic yield and technical notes. Diagnostics (Basel). 2023;13(10):1773. doi: 10.3390/diagnostics13101773.
- 27. Spinnato P, Colangeli M, Rinaldi R, Ponti F. Percutaneous CT-guided bone biopsies: Indications, feasibility and diagnostic yield in the different skeletal sites-from the skull to the toe. Diagnostics (Basel). 2023;13(14):2350. doi: 10.3390/diagnostics13142350.
- 28. Masood S, Mallinson PI, Sheikh A, Ouellette H, Munk PL. Percutaneous bone biopsy. Tech Vasc Interv Radiol. 2022;25(1):100800. doi: 10.1016/j.tvir.2022.100800.
Details
| Primary Language | English |
|---|---|
| Subjects | Radiology and Organ Imaging |
| Journal Section | Articles |
| Authors | |
| Early Pub Date | April 29, 2025 |
| Publication Date | April 29, 2025 |
| Submission Date | September 7, 2024 |
| Acceptance Date | March 10, 2025 |
| Published in Issue | Year 2025 Issue: 25 |
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