title: CT-guided Cervical Bone Biopsy in 43 Patients: Diagnostic Yield and Safety at Two Large Tertiary Care Hospitals.
abstract: The cervical spine is a high-risk area for percutaneous biopsy compared to the thoracic and lumbar regions. Biopsy of the cervical spine is less commonly undertaken, and previously published series on diagnostic yield and safety of cervical spine biopsy have been limited to 12 patients or less. The purpose of our study is to further define the diagnostic yield of computed tomography (CT)-guided biopsy for bony lesions identified in the cervical spine, by combining data from two large tertiary care referral centers.
  
  
  
  A retrospective review of an imaging database was performed to identify all percutaneous CT-guided biopsies of the cervical spine performed at two tertiary care hospitals from 2010 to 2015. Core biopsies were obtained whenever possible and supplemented with fine-needle aspiration in some cases. Histopathologic results of the biopsy were recorded, as were changes in subsequent management, need for repeat biopsy, and complications.
  
  
  
  Forty-three patients underwent CT-guided biopsy of the cervical spine. Sufficient tissue for histopathologic analysis was obtained in 41 out of 43 cases, for a yield of 95%. One case was false-negative and one was deemed insufficient by the pathologist for diagnostic purposes; in both of these cases, only a fine-needle aspiration was obtained. There were no immediate or delayed complications.
  
  
  
  Percutaneous biopsy of the cervical spine is a safe and high-yield method of obtaining a tissue diagnosis when performed under image guidance with CT.
authors.affiliation: Department of Radiology, Thomas Jefferson University, 132 South 10th Street, 1087 Main Building, Philadelphia, PA 19107. Electronic address: mougnyan.cox@gmail.edu.
authors.forename: Mougnyan
authors.initials: M
authors.lastname: Cox
authors.affiliation: Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104.
authors.forename: Bryan
authors.initials: B
authors.lastname: Pukenas
authors.affiliation: Department of Radiology, Thomas Jefferson University, 132 South 10th Street, 1087 Main Building, Philadelphia, PA 19107.
authors.forename: Michael
authors.initials: M
authors.lastname: Poplawski
authors.affiliation: Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104.
authors.forename: Aaron
authors.initials: A
authors.lastname: Bress
authors.affiliation: Department of Radiology, Thomas Jefferson University, 132 South 10th Street, 1087 Main Building, Philadelphia, PA 19107.
authors.forename: Diane
authors.initials: D
authors.lastname: Deely
authors.affiliation: Department of Radiology, Thomas Jefferson University, 132 South 10th Street, 1087 Main Building, Philadelphia, PA 19107.
authors.forename: Adam
authors.initials: A
authors.lastname: Flanders
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000379:methods*
keywords: CT; Cervical; biopsy; complications; percutaneous; safety; spine; yield