Diagnostic Yield of Image-Guided Percutaneous Core Needle Biopsy in Skeletal Lesions: A Retrospective Analysis
DOI:
https://doi.org/10.21276/apalm.3479Keywords:
core needle biopsy, open biopsy, skeletal lesions, histopathogyAbstract
Background: Despite advances in radiology and imaging, histological diagnosis is of paramount importance in the management of musculoskeletal lesions. Traditionally, open biopsies are considered the gold standard but are associated with tumor cell contamination and a high complication rate. These issues can be addressed with a minimally invasive approach using a percutaneous core needle biopsy. In this study, we evaluated the diagnostic yield of core needle biopsy of bone lesions at our institute.
Materials and Methods: This retrospective study of image-guided percutaneous core needle biopsy was conducted on 53 skeletal lesions, and the diagnostic yield of these biopsies was calculated based on the number of diagnostic and non-diagnostic core biopsies.
Results: Among 53 skeletal lesion core needle biopsies, 39 had concordance with final open biopsy or the clinical outcome, making a diagnostic yield of 73.58%. Cystic skeletal lesion biopsies constituted 64.29% of the non-diagnostic core needle biopsies. When cystic lesions were excluded and only solid skeletal lesions were considered, the diagnostic yield improved to 87.80%.
Conclusion: Percutaneous core needle biopsy of solid skeletal lesions is a cheap, less invasive, reliable, accurate, and cost-effective invasive procedure for histological diagnosis of skeletal lesions with the least complication rate. It should be considered as a first-line invasive diagnostic modality for the workup and management of skeletal lesions.
References
1. Osborne RL. The differential radiologic diagnosis of bone tumors. CA Cancer J Clin. 1974;24(4):194-211.
2. 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.
3. Errani C, Traina F, Perna F, Calamelli C, Faldini C. Current concepts in the biopsy of musculoskeletal tumors. ScientificWorldJournal. 2013;2013:538152.
4. Chakrabarti S, Datta AS, Hira M. Critical evaluation of fine needle aspiration cytology as a diagnostic technique in bone tumors and tumor-like lesions. Asian Pac J Cancer Prev. 2012;13(7):3031-5.
5. Tomasian A, Hillen TJ, Jennings JW. Bone biopsies: what radiologists need to know. AJR Am J Roentgenol. 2020;215(3):523-33.
6. Srisawat P, Veeraphun P, Punyaratabandhu T, et al. Comparative study of diagnostic accuracy between office-based closed needle biopsy and open incisional biopsy in patients with musculoskeletal sarcomas. J Med Assoc Thai. 2014;97(Suppl 2):S30-8.
7. Mohit, Dixit S, Sharma R, Sharma P, Kumar P. Evaluation of FNAC in bone lesions. Ann Int Med Den Res. 2019;5(1):PT12-5.
8. Guedes A, Nakagawa SA. Biopsy of bone tumors: a literature review. Rev Assoc Med Bras (1992). 2024;70(Suppl 1):e2024S131.
9. 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):138-43.
10. Adams SC, Potter BK, Pitcher DJ, Temple HT. Office-based core needle biopsy of bone and soft tissue malignancies: an accurate alternative to open biopsy with infrequent complications. Clin Orthop Relat Res. 2010;468(10):2774-80.
11. Suh CH, Yun SJ. Diagnostic outcome of image-guided percutaneous core needle biopsy of sclerotic bone lesions: a meta-analysis. AJR Am J Roentgenol. 2019;212(3):625-31.
12. Ozdemir ZM, Kahraman AS, Baysal T, et al. Image-guided percutaneous bone biopsy with a simulated van Sonnenberg removable hub system. Eurasian J Med. 2015;47(1):1-12.
13. Saifuddin A, Clarke AW. Biopsy of bone and soft tissue sarcomas. In: Bentley G, editor. European surgical orthopaedics and traumatology. Berlin, Heidelberg: Springer; 2014.
14. 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;46:53-6.
15. Sung KS, Seo SW, Shon MS. The diagnostic value of needle biopsy for musculoskeletal lesions. Int Orthop. 2009;33(6):1701-6.
16. 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):457-61.
17. Didolkar MM, Anderson ME, Hochman MG, Rissmiller JG, Goldsmith JD, Gebhardt MG, et al. Image guided core needle biopsy of musculoskeletal lesions: are nondiagnostic results clinically useful? Clin Orthop Relat Res. 2013;471(11):3601-9.
18. Saleem H, Rana AI, Kiani EM, Ramzan MM, Naseem S, Chahudhary MY. Role of non coaxial bone marrow biopsy needle and bone biopsy needle in CT guided core needle biopsies. J Postgrad Med Inst. 2015;29(4):231-6.
19. Taupin T, Decouvelaere AV, Vaz G, Thiesse P. Accuracy of core needle biopsy for the diagnosis of osteosarcoma: a retrospective analysis of 73 patients. Diagn Interv Imaging. 2016;97(3):327-31.
20. Govindan NO, Prasanth J, Gopakumar TS, et al. A study on core cut biopsy in bone lesions. Int J Orthop Sci. 2017;3(1):9-13.
21. Khan I, Saleem MJ, Khan Z, Ahmad I, Saeed M, Khan A. Diagnostic accuracy of core needle biopsy in bone tumors. Results of 100 consecutive cases from a sarcoma unit in Pakistan. EC Orthop. 2020;11(2):1-6.
22. Mohaidat ZM, Al-Gharaibeh SR, Aljararhih ON, Nusairat MT, Al-Omari AA. Challenges in the diagnosis and treatment of aneurysmal bone cyst in patients with unusual features. Adv Orthop. 2019;2019:2905671.
23. 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):e43-7.
24. Espinosa LA, Jamadar DA, Jacobson JA, et al. CT-guided biopsy of bone: a radiologist's perspective. AJR Am J Roentgenol. 2008;190(5):W283-9.
25. Filippiadis DK, Charalampopoulos G, Mazioti A, Keramida K, Kelekis A. Bone and soft-tissue biopsies: what you need to know. Semin Intervent Radiol. 2018;35(4):215-20.
26. Moerenhout K, Gkagkalis G, Omoumi P, Cherix S. Acute leg compartment syndrome after CT-guided core needle biopsy of a giant cell tumor of the proximal fibula. Acta Orthop Belg. 2020;86(4):624-7.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Mehreen Maqsood, Azad Ahmad Shah, Nadeem Ali, Bilal Ahmad Shiekh, Altaf Ahmad Kawoosa
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
