| Analysis of nondiagnostic results after image-guided needle biopsies of musculoskeletal lesions. | |
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MedLine Citation:
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PMID: 20383617 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/RATIONALE: Image-guided needle biopsies are commonly used to diagnose musculoskeletal tumors, but nondiagnostic (ND) results can delay diagnosis and treatment. It is important to understand which factors or diagnoses predispose to a ND result so that appropriate patient education or a possible change in the clinical plan can be made. Currently it is unclear which factors or specific lesions are more likely to lead to a ND result after image-guided needle biopsy. QUESTIONS/PURPOSES: We therefore identified specific factors and diagnoses most likely to yield ND results. We also asked whether an image-guided needle biopsy of bone and soft tissue lesions is an accurate and clinically useful tool. METHODS: We retrospectively reviewed data from a prospectively collected database for a case-control study of 508 image-guided needle biopsies of patients with suspected musculoskeletal tumors between 2003 and 2008. RESULTS: The interpretations of 453 of the 508 (89%) needle biopsies were accurate and clinically useful. Forty-five biopsies (9%) were ND and 10 (2%) were incorrect (IC). Bone lesions had a higher ND rate than soft tissue lesions (13% vs. 4%). The specific diagnosis with the highest ND rate was histiocytosis. Elbow and forearm locations had higher ND rates than average. Malignant tumors had a higher IC rate than benign tumors (5% vs. 0%); fibromyxoid sarcoma and rare subtypes of osteosarcoma had higher IC rates than other diagnoses. Repeat needle or open biopsies were performed in 71 (14%) patients. Bone lesions were more likely than soft tissue lesions to require repeat biopsies (18% vs. 9%). CONCLUSIONS: A high rate of accuracy and clinical usefulness is possible with image-guided needle biopsies of musculoskeletal lesions. We believe these biopsies appropriate in selected circumstances but a key factor for appropriate use is an experienced musculoskeletal tumor team with frequent communication to correlate clinical, radiographic, and histologic information for each patient. |
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Authors:
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Justin Yang; Frank J Frassica; Laura Fayad; Douglas P Clark; Kristy L Weber |
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Publication Detail:
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Type: Journal Article Date: 2010-04-10 |
Journal Detail:
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Title: Clinical orthopaedics and related research Volume: 468 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-09-30 Completed Date: 2010-10-21 Revised Date: 2011-11-01 |
Medline Journal Info:
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Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: United States |
Other Details:
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Languages: eng Pagination: 3103-11 Citation Subset: AIM; IM |
Affiliation:
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Washington University Department of Orthopaedic Surgery, St Louis, MO, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Biopsy, Fine-Needle / methods* Bone Neoplasms / pathology*, radiography, ultrasonography Clinical Competence Delayed Diagnosis / prevention & control Diagnostic Errors / prevention & control Female Humans Logistic Models Male Middle Aged Muscle Neoplasms / pathology*, radiography, ultrasonography Odds Ratio Patient Care Team Predictive Value of Tests Radiography, Interventional* Retrospective Studies Risk Assessment Risk Factors Tomography, X-Ray Computed* Ultrasonography, Interventional* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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