title: CT-Guided Percutaneous Spine Biopsy in Suspected Infection or Malignancy: A Study of 214 Patients.
abstract: Purpose:To retrospectively determine the effectiveness and accuracy of CT-guided percutaneous biopsy of malignant and inflammatory bone lesions of the spine and to assess the reliability of pre-biopsy CT and MRI.Materials and Methods:214 patients with lesions of the spine, which were suspicious either for being malignant or inflammatory, underwent CT-guided biopsy for pathological and/or microbiological detection. Biopsy samples were sent for histological examination in 128/214 patients, for microbiological analysis in 17/214 patients and for both analyses in 69/214 patients. Retrospectively, the diagnostic accuracy and sensitivity/specificity of the pre-interventional imaging (CT and MRI) were determined. In addition, the influence of the biopsy on subsequent patient management was assessed.Results:The accuracy was 94.4 % for histopathological analysis and 97.7 % for microbiological analysis. In 25 % of cases the microbiological analysis revealed an underlying pathogen that was not significantly affected by pre-biopsy antibiotic therapy. The sensitivity/specificity of the pre-biopsy cross-sectional imaging concerning suspected malignancy was 69 %/78 %. For suspected infection, the sensitivity/specificity of pre-biopsy imaging was 81 %/44 %. In 52 % of all cases, the biopsy result changed subsequent patient management.Conclusion:Percutaneous CT-guided spine biopsy is a useful and reliable diagnostic procedure to establish a definitive diagnosis but with a relatively low yield of microorganisms in the case of infection.Key Points:• CT-guided spine biopsy is an accurate and reliable procedure in case of infection and tumour.• The results of the CT-guided spine biopsy have a significant influence on the subsequent patient management.• Pathogen recovery-rate in case of infection is moderate but not significantly affected by prebiopsy antibiotic therapy.Citation Format:• Rehm J, Veith S, Akbar M et al. CT-Guided Percutaneous Spine Biopsy in Suspected Infection or Malignancy: A Study of 214 Patients. Fortschr Röntgenstr 2016; 188: 1156 - 1162.
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Universitiy of Heidelberg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Rehm
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Universitiy of Heidelberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Veith
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Heidelberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Akbar
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Universitiy of Heidelberg, Germany.
authors.forename: H U
authors.initials: HU
authors.lastname: Kauczor
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Universitiy of Heidelberg, Germany.
authors.forename: M A
authors.initials: MA
authors.lastname: Weber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D002648:Child; D003937:Diagnosis, Differential; D015299:Discitis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D055815:Young Adult