Accuracy of computed tomography guided core needle biopsy of musculoskeletal tumours.
BACKGROUND
The accurate diagnosis of musculoskeletal tumours is important for successful treatment. Image guided biopsy is gaining increasing acceptance for obtaining tissue for diagnosis. The aim of the present study is to assess the accuracy of computed tomography (CT)-guided core needle biopsy of musculoskeletal tumours.


METHODS
This is a retrospective study on a series of 127 patients with a musculoskeletal tumour. The biopsies were performed over a 4-year period from 1998 to 2001. The accuracy of the CT-guided core needle biopsy was determined by comparing the histology of the biopsy with the final histology of the specimen obtained at open biopsy or surgical resection of the tumour. The effective accuracy was determined by the accuracy of the biopsy to distinguish between a benign and malignant tumour.


RESULTS
Computed tomography guided core needle biopsy in the present series has an overall accuracy of 80.3%. The effective accuracy as determined by a malignant versus benign lesion was 89%. There were 86 malignant tumours with a biopsy accuracy of 81.4% and there were 41 benign tumours with a biopsy accuracy of 78%. The positive predictive value (PPV) of a malignant tumour is 98.9% and the PPV of benign tumour 90.2%. The most common site of biopsy was from the femur and thigh, together accounting for 39.4% of the tumours. The most common tumours in this series were liposarcoma (n = 12), osteosarcoma (n = 11) and giant cell tumour (n = 11). There were no reported complications arising from the biopsy.


CONCLUSIONS
Computed tomography guided core needle biopsy is a safe and effective procedure that is important in the diagnosis and management of musculoskeletal tumours. It should be performed in a specialized institution with a multidisciplinary musculoskeletal tumour team.
Altuntas
Altay O
AO
Department of Orthopeadics, St Vincent's Hospital, Melbourne, Victoria, Australia.
Slavin
John
J
Smith
Peter J
PJ
Schlict
Stephen M
SM
Powell
Gerard J
GJ
Ngan
Sam
S
Toner
Guy
G
Choong
Peter F M
PF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed