Percutaneous Image-Guided Spinal Lesion Biopsies: Factors Affecting Higher Diagnostic Yield
- Authors
- Yang, So Yeon; Oh, Eunsun; Kwon, Jong Won; Kim, Hyun Su
- Issue Date
- Nov-2018
- Publisher
- American Roentgen Ray Society
- Keywords
- biopsy; CT; fluoroscopy; spine; tumor
- Citation
- American Journal of Roentgenology, v.211, no.5, pp 1068 - 1074
- Pages
- 7
- Journal Title
- American Journal of Roentgenology
- Volume
- 211
- Number
- 5
- Start Page
- 1068
- End Page
- 1074
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/5566
- DOI
- 10.2214/AJR.17.18817
- ISSN
- 0361-803X
1546-3141
- Abstract
- OBJECTIVE. The objectives of this study were to determine the diagnostic yield of percutaneous biopsy of osseous spinal lesions under CT and fluoroscopy guidance and to analyze lesion-related and technical factors affecting higher diagnostic yield. MATERIALS AND METHODS. We retrospectively reviewed 247 consecutive percutaneous spinal biopsies and recorded the following information: size, anatomic location, and bone matrix of lesions; guiding modality; years of attending physicians' experience; number of approaches; pathologic result of initial biopsy; and final diagnosis. The pathologic results of the initial biopsies were classified as diagnostic or nondiagnostic. All variables were compared using Pearson chi-square test or Fisher exact test. Multivariate logistic regression was also conducted. RESULTS. Of the initial 247 biopsies, 197 (80%) biopsies were diagnostic. On multivariate analysis, size, bone matrix, and final diagnosis of lesion were significant factors affecting biopsy yield. Biopsies of large lesions (>= 20 mm) showed higher diagnostic yield than biopsies of small lesions (p = 0.006). Biopsies of lytic lesions had the highest diagnostic yield (88%), followed by biopsies of mixed (84%), sclerotic (67%), and isodense lesions (61%). Differences were significant for diagnostic yields of biopsies of lytic versus sclerotic lesions (p = 0.004) and lytic versus isodense lesions (p = 0.031). Biopsies of metastases had significantly highest diagnostic yield (97%), followed by biopsies of primary malignancies (84%) and benign lesions (39%) (p < 0.05). CONCLUSION. For percutaneous image-guided biopsies of spinal tumorous lesions, diagnostic yield was 80%. Size, bone matrix, and final diagnosis of lesions affected diagnostic yield of percutaneous image-guided biopsies.
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Collections - College of Medicine > Department of Radiology > 1. Journal Articles
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