Computed tomography-guided percutaneous biopsy of bone lesions: rate of diagnostic success and complications.
OBJECTIVE
To determine the rates of diagnostic success and complications of computed tomography (CT)-guided percutaneous biopsy of bone lesions suspected for malignancy.


METHODS
Retrospective study including 186 cases of CT-guided percutaneous biopsies of bone lesions in the period from January, 2010 to December, 2012. All the specimens were obtained with 8-10 gauge needles. The following data were collected: demographics, previous history of malignancy, data related to the lesion, to the procedure, and to histological results.


RESULTS
Most patients were women (57%), and the mean age was 53.0 ± 16.4 years. In 139 cases (74.6%), there was diagnostic suspicion of metastasis and the most common primary tumors were breast (32.1%) and prostate (11.8%). The bones most commonly involved were spine (36.0%), hip (32.8%) and long bones (18.3%). Complications occurred in only three cases (1.6%) including bone fracture, paresthesia with functional impairment, and needle breakage requiring surgical removal. The specimens collected from 183 lesions (98.4%) were considered appropriate for diagnosis. Malignant results were more frequently found in patients who had a suspected secondary lesion and history of known malignancy (p < 0.001), and in patients who underwent PET/CT-guided procedures (p = 0.011).


CONCLUSIONS
CT-guided percutaneous biopsy is a safe and effective procedure for the diagnosis of suspicious bone lesions.
MD, Resident at Imaging Department - A.C.Camargo Cancer Center, São Paulo, SP, Brazil.
Macello Jose Sampaio
MJ
Maciel
Master and Fellow PhD degree, Titular of Imaging Department - A.C.Camargo Cancer Center, São Paulo, SP, Brazil.
Chiang Jeng
CJ
Tyng
Master and Fellow PhD degree, Titular of Imaging Department - A.C.Camargo Cancer Center, São Paulo, SP, Brazil.
Paula Nicole Vieira Pinto
PN
Barbosa
PhD, Titular of Imaging Department - A.C.Camargo Cancer Center, São Paulo, SP, Brazil.
Almir Galvão Vieira
AG
Bitencourt
Master, Fellow of the Interventional Radiology Department - A.C.Camargo Cancer Center, São Paulo, SP, Brazil.
João Paulo Kawaoka
JP
Matushita Junior
Titular of the Interventional Radiology Department - A.C.Camargo Cancer Center, São Paulo, SP, Brazil.
Charles Edouard
CE
Zurstrassen
PhD, Titular of Pelvic Surgery Department - A.C.Camargo Cancer Center, São Paulo, SP, Brazil.
Wu Tu
WT
Chung
PhD, Director, Imaging Department - A.C.Camargo Cancer Center, São Paulo, SP, Brazil.
Rubens
R
Chojniak
Bone neoplasms; Complications; Computed tomography; Interventional radiology; Needle biopsy