Computed tomography-guided percutaneous biopsy for vertebral neoplasms: A department's experience and hybrid biopsy technique to improve yield

Vasant Garg, Christos Kosmas, Enambir S. Josan, Sasan Partovi, Nicholas Bhojwani, Nathan Fergus, Peter C. Young, Mark R. Robbin

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Objective Recent articles have identified the poor diagnostic yield of percutaneous needle biopsy for vertebral osteomyelitis. The current study aimed to confirm the higher accuracy of CT-guided spinal biopsy for vertebral neoplasms and to identify which biopsy technique provides the highest yield. Methods Over a 9-year period, the radiology department at University Hospitals Case Medical Center performed 222 CT-guided biopsies of vertebral lesions, of which clinicians indicated a concern for vertebral neoplasms in 122 patients. A retrospective chart review was performed to confirm the higher sensitivity of the percutaneous intervention for vertebral neoplasms. Results A core sample was obtained for all 122 biopsies of concern (100.0%). Only 6 cases (4.9%) were reported as nondiagnostic per histological sampling, and 12 cases (9.8%) were negative for disease. The question of vertebral neoplastic involvement warrants follow-up, and the current study was able to determine the subsequent diagnosis of each lesion. Of the 122 total, 94 (77.0%) core samples provided true-positive results, and the sensitivity of core biopsy measured 87.9%. The technical approach did not demonstrate any significant difference in diagnostic yield. However, when the vertebral cortex was initially pierced with a coaxial bone biopsy system and subsequently a 14-gauge spring-loaded cutting biopsy needle was coaxially advanced into lytic lesions, 14 true positives were obtained with a corresponding sensitivity of 100.0%. Conc lusions This study confirms the higher sensitivity of image-guided percutaneous needle biopsy for vertebral neoplasms. In addition, it demonstrates how the use of a novel cutting needle biopsy approach, performed coaxially through a core biopsy track, provides the highest yield.

Original languageEnglish (US)
Article numberE17
JournalNeurosurgical focus
Volume41
Issue number2
DOIs
StatePublished - 2016

Keywords

  • CT-guided biopsy
  • Hybrid biopsy technique
  • Vertebral neoplasms

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Computed tomography-guided percutaneous biopsy for vertebral neoplasms: A department's experience and hybrid biopsy technique to improve yield'. Together they form a unique fingerprint.

Cite this