Image-guided core needle biopsy for musculoskeletal lesions.
Autor: | Toki S; Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan. Electronic address: toki830926@gmail.com., Sone M; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan., Yoshida A; Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan; Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan., Nishisho T; Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan., Gokita T; Department of Orthopedic Oncology, Saitama Cancer Center, Saitama, Japan., Kobayashi E; Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan., Nakatani F; Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan., Chuman H; Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan., Sugawara S; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan., Arai Y; Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan., Kawai A; Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan. |
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Jazyk: | angličtina |
Zdroj: | Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association [J Orthop Sci] 2022 Mar; Vol. 27 (2), pp. 448-455. Date of Electronic Publication: 2021 Jan 30. |
DOI: | 10.1016/j.jos.2020.12.017 |
Abstrakt: | Background: Image-guided percutaneous core needle biopsy (CNB) has been an important diagnostic procedure for musculoskeletal lesions. Here we surveyed the variety of diagnostic strategies available and assessed the clinical usefulness and limitations of image-guided CNB carried out by a multidisciplinary team comprising specialists in various fields. Methods: We conducted a retrospective study of 284 image-guided CNBs among 1899 consecutive biopsy procedures carried out at our institution for musculoskeletal tumorous conditions, focusing on their effectiveness including diagnostic accuracy and utility for classification of specimens according to malignant potential and histological subtype as well as their correlation with biopsy routes. Results: Among the 284 studied biopsies, 252 (88.7%) were considered clinically "effective". The sensitivity for detection of malignancy was 94.0% (110/117) and the specificity was 95.3% (41/43). The diagnostic accuracy for detection of malignancy was 94.4% (151/160) and that for histological subtype was 92.3% (48/52). The clinical effectiveness of the procedure was correlated with the complexity of the biopsy route (P = 0.015); the trans-pedicular, trans-retroperitoneal and trans-sciatic foramen approaches tended to yield ineffective results. Repeat biopsy did not have a significant impact on the effectiveness of image-guided CNB (P = 0.536). Conclusions: The diagnostic accuracy rates of image-guided CNB performed at multidisciplinary sarcoma units were usable even for patients who have variety of diagnostic biopsy procedures. It is important to establish and implement diagnostic strategies based on an understanding that complicated routes, especially for spine and pelvic lesions, may be associated with ineffectiveness and/or complications. Competing Interests: Declaration of competing interest Dr. Arai reported receiving the lecture fee from Canon Medical System. No other disclosures were reported. (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.) |
Databáze: | MEDLINE |
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