Percutaneous CT-Guided Bone Biopsies: Indications, Feasibility and Diagnostic Yield in the Different Skeletal Sites—From the Skull to the Toe
Abstract
:1. Introduction
1.1. Biopsy: General Concepts
1.2. History
1.3. Image Guidance
1.4. Clinical Indications
1.5. Contraindications and Complications
2. CT-Guided Skeletal Biopsy: Feasibility and Diagnostic Yield in Different Skeletal Sites
2.1. Skull
2.2. Skull Base and Craniovertebral Junction (C0–C2)
2.3. The Spine
2.4. Ribs and Sternum
2.5. The Pelvis
2.6. Appendicular Skeleton
Hands and Feet
3. Factors Influencing the Diagnostic Yield
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Affected Skeletal Region | Radiologic Pattern | Imaging Guidance |
---|---|---|
Appendicular skeleton | Sclerotic pattern, osteolytic or mixed pattern without cortical disruption or intramedullary only involvement | CT, Fluoroscopy |
Appendicular Skeleton | Osteolytic or mixed pattern with cortical disruption or cortical thinning | Ultrasound, CT, Fluoroscopy |
Pelvic bones | Lesions without large extra-skeletal soft tissue involvement | CT |
Pelvic bones | Osteolytic or mixed with large soft tissue extra-skeletal involvement | CT, Ultrasound |
Spine | All | CT |
Spine | Large lesions of the vertebral body | CT, Fluoroscopy |
Spine | Large lesions with posterior extra-osseous involvement | CT, Ultrasound |
Ribs | Osteolytic or mixed pattern with cortical disruption or cortical thinning | CT, Ultrasound |
Ribs | Sclerotic pattern, osteolytic or mixed pattern without cortical disruption or intramedullary only involvement | CT |
Sternum | All | CT |
Sternum | Anterior extra-skeletal soft tissue involvement | CT, Ultrasound |
Skull and Craniovertebral junction | All | CT |
Factors Associated with a Lower Diagnostic Rate | Factors Associated with a Higher Diagnostic Rate |
---|---|
Sclerotic radiologic pattern | Lytic or mixed radiologic pattern |
Location in the appendicular skeleton | Location in the axial skeleton |
Small lesion size | Large lesion size |
Single bone sample | Multiple bone samples |
Short sample (short needle penetration in the tumor/perpendicular needle trajectory) | Large sample (long needle penetration in the tumor/oblique needle trajectory) |
(Spondylodiscitis/Osteomyelitis) Targeting the bone only | (Spondylodiscitis/Osteomyelitis) Targeting soft tissue involvement and/or fluid collection aspiration. |
Target lesion not visible in CT | Target lesion visible in CT |
Benign final diagnosis | Malignant final diagnosis |
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Spinnato, P.; Colangeli, M.; Rinaldi, R.; Ponti, F. Percutaneous CT-Guided Bone Biopsies: Indications, Feasibility and Diagnostic Yield in the Different Skeletal Sites—From the Skull to the Toe. Diagnostics 2023, 13, 2350. https://doi.org/10.3390/diagnostics13142350
Spinnato P, Colangeli M, Rinaldi R, Ponti F. Percutaneous CT-Guided Bone Biopsies: Indications, Feasibility and Diagnostic Yield in the Different Skeletal Sites—From the Skull to the Toe. Diagnostics. 2023; 13(14):2350. https://doi.org/10.3390/diagnostics13142350
Chicago/Turabian StyleSpinnato, Paolo, Marco Colangeli, Raffaella Rinaldi, and Federico Ponti. 2023. "Percutaneous CT-Guided Bone Biopsies: Indications, Feasibility and Diagnostic Yield in the Different Skeletal Sites—From the Skull to the Toe" Diagnostics 13, no. 14: 2350. https://doi.org/10.3390/diagnostics13142350