DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20171903

A retrospective analysis of computed tomography guided biopsy in the diagnosis of primary bone tumors

Kuriakku Puthur Dominic, Davis Dijoe, Jacob Toms

Abstract


Background: Primary bone tumors account for a small yet significant number in the total incidence of tumors. Computed tomography (CT) guided percutaneous core biopsy is a novel yet significant step in the approach towards the diagnosis of bone tumors and is increasingly performed by orthopaedic oncologists around the world. This study is aimed to evaluate the diagnostic accuracy of CT guided biopsy in the diagnosis of primary bone tumors.

Methods: Patients who underwent CT guided biopsy and subsequent excision for primary bone tumors from January 2008 to July 2015 were analysed. CT guided biopsy results were compared with post-operative histopathological reports to evaluate its sensitivity and specificity.

Results: A total of 161 patients were included in the retrospective study. Among them, 147 were true positives, 7 were false negatives, 6 were true negatives and one was false positive. The sensitivity of CT guided biopsy in the diagnosis of primary bone tumor was 95.4 % with specificity of 85.7% with a diagnostic efficiency of 90.5%. The complication rate was 4.3%.

Conclusions: CT guided biopsy is a safe, simple and effective procedure to rule out and rule in the diagnosis of primary bone tumors.


Keywords


CT guided biopsy, Sensitivity, Specificity, Histopathology report, Primary bone tumors

Full Text:

PDF

References


Heare TC, Enneking WF, Heare MM. Staging techniques and biopsy of bone tumors. Orthop Clin North Am.1989;20(3):273-85.

Didolkar MM, Anderson ME, Hochman MG, Rissmiller JG, Goldsmith JD, Gebhardt MG, Wu JS. Image guided core needle biopsy of musculoskeletal lesions: are nondiagnostic results clinically useful? Clin Orthop Related Res. 2013;471(11):3601-9.

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):644-9.

Boriani S, Ruggieri P, Sudanese A. Biopsy: considerations on surgical technique derived from a study of 749 cases of bone tumour. Italian J Orthop Traumatol. 1984;10(4):489-99.

Mankin HJ, Lange TA, Spanier SS. The hazards of biopsy in patients with malignant primary bone and soft-tissue tumors. J Bone Joint Surg Am. 1982;64(8):1121-7.

Mankin HJ, Mankin CJ, Simon MA. The hazards of the biopsy, revisited. For the members of the Musculoskeletal Tumor Society. J Bone Joint Surg Am. 1996;78(5):656-3.

Altuntas AO, Slavin J, Smith PJ, Schlict SM, Powell GJ, Ngan S, Toner G, Choong PF. Accuracy of computed tomography guided core needle biopsy of musculoskeletal tumours. ANZ J Surg. 2005;75(4):187-91.

Dupuy DE, Rosenberg AE, Punyaratabandhu T, Tan MH, Mankin HJ. Accuracy of CT-guided needle biopsy of musculoskeletal neoplasms. Am J Roentgenol. 1998;71(3):759-62.

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.

Jelinek JS, Murphey MD, Welker JA, Henshaw RM, Kransdorf MJ, Shmookler BM, et al. Diagnosis of Primary Bone Tumors with Image-guided Percutaneous Biopsy: Experience with 110 Tumors. Radiol. 2002;223(3):731-7.

Martin HE, Ellis EB. Biopsy by needle puncture and aspiration. Ann Surg. 1930;92(2):169.

Snyder RE, Coley BL. Further studies on the diagnosis of bone tumors by aspiration biopsy. Surg Gynecol Obstet. 1945;80(5):517-22.

Ottolenghi CE. Diagnosis of orthopaedic lesions by aspiration biopsy. J Bone Joint Surg Am. 1955;37(3):443-64.

Schajowicz F, Derqui JC. Puncture biopsy in lesions of the locomotor system: review of results in 4050 cases, including 941 vertebral punctures. Cancer. 1968;21(3):531-48.

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? Radiol. 2008;248(3):962-70.

Aisen AM, Martel W, Braunstein EM, McMillin KI, Phillips WA, Kling TF. MRI and CT evaluation of primary bone and soft-tissue tumors. Am J Roentgenol. 1986;146(4):749-56.

Steil S, Zerwas S, Moos G, Bittinger F, Hansen T, Mergenthaler U, Weide R. CT-guided percutaneous core needle biopsy in oncology outpatients: sensitivity, specificity, complications. Onkologie. 2009;32(5):254-8.

Welker JA, Henshaw RM, Jelinek J, Shmookler BM, Malawer MM. The percutaneous needle biopsy is safe and recommended in the diagnosis of musculoskeletal masses. Cancer. 2000;89(12):2677-86.

Traina F, Errani C, Toscano A, Pungetti C, Fabbri D, Mazzotti A, Donati D, Faldini C. Current concepts in the biopsy of musculoskeletal tumors. J Bone Joint Surg. 2015;97(2):e7.