title: Radiation dose reduction in CT-guided spine biopsies does not reduce diagnostic yield.
abstract: OBJECTIVE
  CT-guided biopsy is the most commonly used method to obtain tissue for diagnosis in suspected cases of malignancy involving the spine. The purpose of this study was to demonstrate that a low-dose CT-guided spine biopsy protocol is as effective in tissue sampling as a regular-dose protocol, without adversely affecting procedural time or complication rates.
  
  
  METHODS
  We retrospectively reviewed all patients who underwent CT-guided spine procedures at our institution between May 2010 and October 2013. Biopsy duration, total number of scans, total volume CT dose index, total dose-length product, and diagnostic tissue yield of low-dose and regular-dose groups were compared.
  
  
  RESULTS
  Sixty-four patients were included, of whom 31 underwent low-dose and 33 regular-dose spine biopsies. There was a statistically significant difference in total volume CT dose index and total dose-length product between the low-dose and regular-dose groups (P < .0001). There was no significant difference in the total number of scans obtained (P = .3385), duration of procedure (P = .149), or diagnostic tissue yield (P = .6017).
  
  
  CONCLUSIONS
  Use of a low-dose CT-guided spine biopsy protocol is a practical alternative to regular-dose approaches, maintaining overall quality and efficiency at reduced ionizing radiation dose.
authors.affiliation: From the Department of Radiology, Icahn School of Medicine, Mount Sinai Health System, New York, New York.
authors.forename: K A
authors.initials: KA
authors.lastname: Shpilberg
authors.affiliation: From the Department of Radiology, Icahn School of Medicine, Mount Sinai Health System, New York, New York.
authors.forename: B N
authors.initials: BN
authors.lastname: Delman
authors.affiliation: From the Department of Radiology, Icahn School of Medicine, Mount Sinai Health System, New York, New York.
authors.forename: L N
authors.initials: LN
authors.lastname: Tanenbaum
authors.affiliation: From the Department of Radiology, Icahn School of Medicine, Mount Sinai Health System, New York, New York.
authors.forename: S J
authors.initials: SJ
authors.lastname: Esses
authors.affiliation: From the Department of Radiology, Icahn School of Medicine, Mount Sinai Health System, New York, New York.
authors.forename: R
authors.initials: R
authors.lastname: Subramaniam
authors.affiliation: From the Department of Radiology, Icahn School of Medicine, Mount Sinai Health System, New York, New York. doshia@gmail.com amish.doshi@mountsinai.org.
authors.forename: A H
authors.initials: AH
authors.lastname: Doshi
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000601:surgery*; D013131:Spine; D014057:Tomography, X-Ray Computed / Q000379:methods*