CT-guided bone biopsy in cancer patients with suspected bone metastases: retrospective review of 308 procedures.
OBJECTIVE
The authors assessed the adequacy and sensitivity of CT-guided bone biopsy in 308 procedures performed in 286 cancer patients with suspected bone metastases.


METHODS
An electronic search of our CT-guided bone biopsy database was retrospectively performed to evaluate the adequacy of samples and, in the event of negative samples, whether the patients had radiological progression at the site of biopsy (false negative). Adequacy and false-negative rate were compared with radiological features, biopsy location, specimen length and complications to assess any statistically relevant association with a multivariate logistic regression model.


RESULTS
A total of 290/308 (94.1 %) samples were adequate. Forty-five patients had normal bone marrow and were followed-up, with evidence of progression at the site of biopsy in 10 cases (false-negative cases); overall sensitivity was 96.7 %. Specimen length was significantly correlated to the probability of an adequate biopsy (p = 0.035) and inversely correlated to the probability to obtain a false-negative result (p = 0.02). We encountered 11/308 (3.5 %) minor complications and no major complications.


CONCLUSIONS
CT-guided biopsy of bone lesions in cancer patients allows for a final diagnosis in 94 % of cases. A specimen longer than 1 cm may lead to a significant result in terms of adequacy and sensitivity. Negative biopsies with positive positron emission tomography or magnetic resonance imaging and specimen shorter than 1 cm should be repeated to avoid a false-negative result.
Department of Radiology Milan, European Institute of Oncology, Via Ripamonti 435, 20100, Milan, Italy, lorenzo.monfardini@ieo.it.
Lorenzo
L
Monfardini
Lorenzo
L
Preda
Gaetano
G
Aurilio
Stefania
S
Rizzo
Vincenzo
V
Bagnardi
Giuseppe
G
Renne
Sara
S
Maccagnoni
Paolo Della
PD
Vigna
Disalvatore
D
Davide
Massimo
M
Bellomi
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000556:secondary; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed