Initial CT-guided needle biopsy of extremity skeletal lesions: diagnostic performance and experience of a tertiary musculoskeletal center.
BACKGROUND
Appendicular long bones are the target for a wide spectrum of bony lesions with variable clinical presentations. Biopsy procedures are needed for subsequent proper patient's management. Most of the available literature globally assessed musculoskeletal biopsies with inclusion of repeat biopsy results. We thought to retrospectively assess the diagnostic performance of initial CT-guided percutaneous core needle biopsy (PCNB) of extremity long bone lesions in a tertiary musculoskeletal referral center.


METHODS
We retrospectively analyzed the outcome of initial CT-guided PCNB of 49 patients who presented with extremity long bone lesions which were biopsied in our hospital during a 36 months' time period. The diagnostic performance was assessed in terms of diagnostic yield and accuracy.


RESULTS
There were 34 males and 15 females with a mean age of 33.69 years (range from 4 to 77 years). The overall diagnostic yield of initial biopsies was 87.75% with a diagnostic accuracy of 82.85% derived from the surgically proven cases. The higher diagnostic yield was recorded with malignancy, presence of extra-osseous soft-tissue component as well as mixed and sclerotic lesions. The pathologies of the non-diagnostic biopsies included large-cell lymphoma, giant-cell tumor, langerhans cell histiocytosis, osteoid osteoma and a non-ossifying fibroma.


CONCLUSIONS
Initial CT-guided PCNB in extremities' long bones lesions showed high diagnostic performance in malignant, mixed and/or sclerotic lesions as well as lesions with extra-osseous exophytic tissue growth. Lack of extra-osseous components, benign and lytic lesions all had worse diagnostic performance.
Department of Radiology, Faculty of Medicine, Alexandria University, Egypt; Department of Radiology, Al-Razi Hospital, Sulibikhate 13001, Kuwait. Electronic address: mragab73@yahoo.com.
Mohamed Ragab
MR
Nouh
Department of Radiology, Al-Razi Hospital, Sulibikhate 13001, Kuwait. Electronic address: hamdi_abushadi@yahoo.com.
Hamdy Mohamed
HM
Abu Shady
D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D002675:Child, Preschool; D005121:Extremities / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015641:Radiography, Interventional / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D062606:Tertiary Care Centers; D055815:Young Adult
Biopsy; CT-guided; Extremity; Percutaneous; Skeletal