Pearls and Pitfalls for Soft-Tissue and Bone Biopsies: A Cross-Institutional Review.

Autor:	Meek RD; From the Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239 (R.D.M., B.R.B., S.S., B.G.H.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (M.K.M., C.J.H., R.L.L., H.A.); Department of Diagnostic Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (D.D.W.); and private practice, Eugene, Ore (M.T.)., Mills MK; From the Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239 (R.D.M., B.R.B., S.S., B.G.H.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (M.K.M., C.J.H., R.L.L., H.A.); Department of Diagnostic Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (D.D.W.); and private practice, Eugene, Ore (M.T.)., Hanrahan CJ; From the Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239 (R.D.M., B.R.B., S.S., B.G.H.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (M.K.M., C.J.H., R.L.L., H.A.); Department of Diagnostic Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (D.D.W.); and private practice, Eugene, Ore (M.T.)., Beckett BR; From the Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239 (R.D.M., B.R.B., S.S., B.G.H.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (M.K.M., C.J.H., R.L.L., H.A.); Department of Diagnostic Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (D.D.W.); and private practice, Eugene, Ore (M.T.)., Leake RL; From the Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239 (R.D.M., B.R.B., S.S., B.G.H.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (M.K.M., C.J.H., R.L.L., H.A.); Department of Diagnostic Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (D.D.W.); and private practice, Eugene, Ore (M.T.)., Allen H; From the Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239 (R.D.M., B.R.B., S.S., B.G.H.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (M.K.M., C.J.H., R.L.L., H.A.); Department of Diagnostic Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (D.D.W.); and private practice, Eugene, Ore (M.T.)., Williams DD; From the Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239 (R.D.M., B.R.B., S.S., B.G.H.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (M.K.M., C.J.H., R.L.L., H.A.); Department of Diagnostic Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (D.D.W.); and private practice, Eugene, Ore (M.T.)., Tommack M; From the Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239 (R.D.M., B.R.B., S.S., B.G.H.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (M.K.M., C.J.H., R.L.L., H.A.); Department of Diagnostic Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (D.D.W.); and private practice, Eugene, Ore (M.T.)., Schmahmann S; From the Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239 (R.D.M., B.R.B., S.S., B.G.H.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (M.K.M., C.J.H., R.L.L., H.A.); Department of Diagnostic Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (D.D.W.); and private practice, Eugene, Ore (M.T.)., Hansford BG; From the Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239 (R.D.M., B.R.B., S.S., B.G.H.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (M.K.M., C.J.H., R.L.L., H.A.); Department of Diagnostic Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (D.D.W.); and private practice, Eugene, Ore (M.T.).
Jazyk:	angličtina
Zdroj:	Radiographics : a review publication of the Radiological Society of North America, Inc [Radiographics] 2020 Jan-Feb; Vol. 40 (1), pp. 266-290.
DOI:	10.1148/rg.2020190089
Abstrakt:	Management of soft-tissue and bone neoplasms depends on a definitive histologic diagnosis. Percutaneous image-guided biopsy of bone and soft-tissue tumors is a cost-effective and accurate method to obtain a histopathologic diagnosis. Biopsy requests must be approached thoughtfully to avoid numerous potential pitfalls. Hasty biopsy planning places the patient at increased risk for misdiagnosis, delayed therapy, repeated invasive procedures, and substantial morbidity. Biopsy planning begins with a thorough review of the relevant clinical history and pertinent imaging. The biopsy route must be planned in concert with the referring orthopedic oncologist to preserve limb-sparing options. Carefully selecting the most appropriate imaging modality to guide the biopsy increases the chances of reaching a definitive diagnosis. It is also critical to identify and target with expertise the part of the lesion that is most likely to yield an accurate diagnosis. Percutaneous biopsy is a safe procedure, and familiarity with preprocedural laboratory testing parameters, anticoagulation guidelines, and commonly used sedation medications minimizes the risk of complications while ensuring patient comfort. Nondiagnostic biopsy results are not infrequent and may still have value in guiding patient treatment. Awareness of the imaging manifestations of tumor recurrence is also important. The aim of this article is to provide a comprehensive review of pertinent preprocedural, periprocedural, and postprocedural considerations for bone and soft-tissue musculoskeletal biopsies. The online slide presentation from the RSNA Annual Meeting is available for this article. © RSNA, 2020.
Databáze:	MEDLINE
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